Provider Demographics
NPI:1194280909
Name:SIEGEL, VICTORIA (MS, LMHC, LPC)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:
Last Name:SIEGEL
Suffix:
Gender:F
Credentials:MS, LMHC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10299 SOUTHERN BLVD UNIT 211773
Mailing Address - Street 2:
Mailing Address - City:ROYAL PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33421-5071
Mailing Address - Country:US
Mailing Address - Phone:561-203-9223
Mailing Address - Fax:
Practice Address - Street 1:1635 RENAISSANCE COMMONS BLVD APT 2307
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33426-8381
Practice Address - Country:US
Practice Address - Phone:561-203-9223
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-06
Last Update Date:2021-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID6163101Y00000X
FL15491101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor