Provider Demographics
NPI:1174994214
Name:SIEGEL, KAREN (LCSW)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:SIEGEL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3486 CHELAN DR
Mailing Address - Street 2:
Mailing Address - City:WEST LINN
Mailing Address - State:OR
Mailing Address - Zip Code:97068-8205
Mailing Address - Country:US
Mailing Address - Phone:727-515-5071
Mailing Address - Fax:
Practice Address - Street 1:2240 TWELVE OAKS WAY
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33544-6970
Practice Address - Country:US
Practice Address - Phone:813-838-4807
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-15
Last Update Date:2019-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW165061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical