# AMY SIEGEL LICSW LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1821515685
- **Authorized official:** AMY SIEGEL LICSW (OWNER)
- **Authorized official phone:** (802) 865-3450

## Contact information

- **Practice address:** 86 LAKE ST, BURLINGTON, VT 05401-5297
- **Practice address phone:** (802) 865-3450
- **Practice address fax:** (802) 860-5011
- **Mailing address:** 86 LAKE ST, BURLINGTON, VT 05401-5297
- **Mailing address phone:** (802) 865-3450
- **Mailing address fax:** (802) 860-5011

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | 089-0001188 | VT | Yes |

## Other

- **Enumeration date:** 08/23/2017
- **Last updated:** 07/21/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1013883 | — | VT |