Roy E Siegfriedt, LCPC

Individual provider Active NPI Professional Counselor · Randolph, ME

NPI 1457549834 · NPPES record last updated Oct 10, 2007

Key facts

NPI
1457549834
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
CC686 (ME)
Practice address
9 Hillcrest Ave
Randolph, ME 04346-5131
Phone
(207) 582-4218
Fax
(207) 582-4360
NPI assigned
Oct 10, 2007
Sex
Male
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
CC686MEMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Spurwink Services Incorporated Past
since Dec 5, 2011
Accepting new patients
Spurwink Services Incorporated Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X CC686 ME Yes

Addresses

Primary practice location

9 Hillcrest Ave
Randolph, ME 04346-5131

Mailing address

899 Riverside St
Portland, ME 04103-1070
Phone (207) 871-1200

Other identifiers

IdentifierTypeStateIssuer
098312OtherMEANTHEM

Other providers in Randolph, ME

All providers in Randolph, ME · Professional Counselor in Maine

Sources for this page

Verify at the official NPI Registry.