Individual
DR. ELLEN BETH SIEGEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
187 MOUNT AUBURN ST, CAMBRIDGE, MA 02138-4863
(617) 826-9450
(617) 722-4954
Mailing address
122 NEHOIDEN RD, WABAN, MA 02468-1926
(617) 826-9450
(617) 722-4954
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
7739
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110085068A
—
MA
01
—
1103210
NEIGHBORHOOD HEALTH PLAN
MA
01
—
1821168501
HARVARD PILGRIM HEALTHCARE
MA
01
—
W06211
BLUE CROSS/BLUE SHIELD
MA
Enumeration date
11/09/2006
Last updated
11/02/2010
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