Pamela D Siemon, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

009745 Issued in CT

Practice address

51 Depot St Ste 207
Watertown, CT 06795

Phone

(203) 232-8009

NPI assigned

Sep 18, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Pamela D Siemon Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 4, 2022 through Jan 4, 2028

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1347926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531180800000",
    "number": "1821348871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 QUASSUK RD",
            "city": "WOODBURY",
            "state": "CT",
            "postal_code": "067982013",
            "telephone_number": "203-263-2821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 DEPOT ST STE 207",
            "city": "WATERTOWN",
            "state": "CT",
            "postal_code": "06795",
            "telephone_number": "203-232-8009"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "89 Old Mamaroneck Rd",
            "address_purpose": "LOCATION",
            "city": "White Plains",
            "state": "NY",
            "postal_code": "106051903",
            "country_code": "US",
            "telephone_number": "203-232-8009",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIEMON",
        "first_name": "PAMELA",
        "middle_name": "D",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-18",
        "last_updated": "2018-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "085929",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "009745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PAMELA",
            "last_name": "SIEMON",
            "middle_name": "D",
            "credential": "LCSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Clinical Social Worker in Watertown, CT
• Providers in Watertown, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.