Organization
AMY SIEGEL LICSW LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY SIEGEL LICSW (OWNER)
(802) 865-3450
Entity
Organization
Contact information
Practice address
86 LAKE ST, BURLINGTON, VT 05401-5297
(802) 865-3450
(802) 860-5011
Mailing address
86 LAKE ST, BURLINGTON, VT 05401-5297
(802) 865-3450
(802) 860-5011
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
089-0001188
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1013883
—
VT
Enumeration date
08/23/2017
Last updated
07/21/2022
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