Provider Demographics
NPI:1326767864
Name:SIEGEL, MONICA
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:SIEGEL
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:MONICA
Other - Middle Name:
Other - Last Name:DOUGLASS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4488 PEPPERWOOD HL SE
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52403-1069
Mailing Address - Country:US
Mailing Address - Phone:319-430-8081
Mailing Address - Fax:
Practice Address - Street 1:1214 DINA CT STE A
Practice Address - Street 2:
Practice Address - City:HIAWATHA
Practice Address - State:IA
Practice Address - Zip Code:52233-4706
Practice Address - Country:US
Practice Address - Phone:319-208-2150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-26
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA113959106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist