Provider Demographics
NPI:1063977783
Name:SIEGMAN, VALERIE (MA, LMHC, PLLC)
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:
Last Name:SIEGMAN
Suffix:
Gender:F
Credentials:MA, LMHC, PLLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1037 ROYAL PASS RD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33602-5724
Mailing Address - Country:US
Mailing Address - Phone:813-951-7786
Mailing Address - Fax:
Practice Address - Street 1:1037 ROYAL PASS RD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33602-5724
Practice Address - Country:US
Practice Address - Phone:813-255-4180
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-06
Last Update Date:2019-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH16684101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health