Individual provider Active NPI

Edie Siemann, LMFT & LMHC

  • Marriage & Family Therapist
  • Gainesville, FL
National Provider Identifier
1518403807
Registry record updated Jan 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MT 2804 Issued in FL
Practice address
2830 NW 41St St
J
Gainesville, FL 32606-6667
Phone
(352) 284-3747
NPI assigned
Jan 11, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 11, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MH 11836 FL
Marriage & Family Therapist 106H00000X MT 2804 FL Primary

Addresses

Primary practice location

2830 NW 41St St
J
Gainesville, FL 32606-6667

Mailing address

2830 NW 41St St
J
Gainesville, FL 32606-6667
Phone (352) 284-3747

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MH 11836FLMDMental Health Counselor
MT 2804FLMDMarriage & Family Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1484092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484092800000",
    "number": "1518403807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2830 NW 41ST ST",
            "address_2": "J",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326066667",
            "telephone_number": "352-284-3747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2830 NW 41ST ST",
            "address_2": "J",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326066667",
            "telephone_number": "352-284-3747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIEMANN",
        "first_name": "EDIE",
        "credential": "LMFT & LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-01-11",
        "last_updated": "2017-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH 11836",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "FL",
            "license": "MT 2804",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.