Active NPI
Joelle Valvo Siegel, PSY.D.
- Clinical Psychologist
- Bangor, ME
National Provider Identifier
1467573873
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PS971
- Practice address
- 6 State St
Suite 413
Bangor, ME 04401-5112 - Phone
- (207) 942-9600
- Fax
- (207) 942-2627
- NPI assigned
- Apr 3, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PS971 | ME | Primary |
| Cognitive & Behavioral Psychologist | 103TB0200X | PS971 | ME | |
| Clinical Child & Adolescent Psychologist | 103TC2200X | PS971 | ME | |
| Family Psychologist | 103TF0000X | PS971 | ME | |
| Forensic Psychologist | 103TF0200X | PS971 | ME | |
| Group Psychotherapy Psychologist | 103TP2701X | PS971 | ME |
Addresses
Primary practice location
6 State St
Suite 413
Bangor, ME 04401-5112
Mailing address
6 State St
Suite 413
Bangor, ME 04401-5112
Phone (207) 942-9600
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 289950000 | Medicaid | ME |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS971 | ME | MD | Family Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175558400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1462147200000",
"number": "1467573873",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6 STATE ST",
"address_2": "SUITE 413",
"city": "BANGOR",
"state": "ME",
"postal_code": "044015112",
"telephone_number": "207-942-9600",
"fax_number": "207-942-2627"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6 STATE ST",
"address_2": "SUITE 413",
"city": "BANGOR",
"state": "ME",
"postal_code": "044015112",
"telephone_number": "207-942-9600",
"fax_number": "207-942-2627"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIEGEL",
"first_name": "JOELLE",
"middle_name": "VALVO",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-03",
"last_updated": "2016-05-02",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "ME",
"license": "PS971",
"primary": true
},
{
"code": "103TB0200X",
"taxonomy_group": "",
"desc": "Psychologist, Cognitive & Behavioral",
"state": "ME",
"license": "PS971",
"primary": false
},
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "ME",
"license": "PS971",
"primary": false
},
{
"code": "103TF0000X",
"taxonomy_group": "",
"desc": "Psychologist, Family",
"state": "ME",
"license": "PS971",
"primary": false
},
{
"code": "103TF0200X",
"taxonomy_group": "",
"desc": "Psychologist, Forensic",
"state": "ME",
"license": "PS971",
"primary": false
},
{
"code": "103TP2701X",
"taxonomy_group": "",
"desc": "Psychologist, Group Psychotherapy",
"state": "ME",
"license": "PS971",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "289950000",
"state": "ME"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bangor, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.