Individual provider Active NPI

Sandra Siegal, LCSW

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1700331857
Registry record updated Aug 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
039180-1R Issued in NY
Practice address
315 E 68TH St
Apt 5RS
New York, NY 10065-5692
Phone
(212) 879-0781
NPI assigned
Aug 18, 2016
Last updated
Aug 18, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 18, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 039180-1R NY Primary

Addresses

Primary practice location

315 E 68TH St
Apt 5RS
New York, NY 10065-5692

Mailing address

315 E 68TH St
Apt 5RS
New York, NY 10065-5692
Phone (212) 879-0781

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
039180-1RNYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1471478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471478400000",
    "number": "1700331857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 E 68TH ST",
            "address_2": "APT 5RS",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100655692",
            "telephone_number": "212-879-0781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 E 68TH ST",
            "address_2": "APT 5RS",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100655692",
            "telephone_number": "212-879-0781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIEGAL",
        "first_name": "SANDRA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-18",
        "last_updated": "2016-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "039180-1R",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 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.

Verify at the official NPI Registry.