JON HOWARD SIEGEL PH.D. NPI 1124149513

NPI Information

NPI: 1124149513
Provider Name: JON HOWARD SIEGEL, PH.D.
Classification: Psychologist - 103TA0400X
Entity Type: Individual

Specialization: Addiction (Substance Use Disorder)

PECOS Registration: Yes

Address:
6 STATE ST
SUITE 413
BANGOR, ME
ZIP 04401
Phone: (207) 942-2627
Get Directions

Jon Howard Siegel, PH.D. is an addiction (substance use disorder) psychologist in Bangor, ME. The provider is a psychologist with a proficiency that involves the application of psychological treatment of addiction stemming from the use of alcohol and other psychoactive substances (e.g., nicotine, marijuana, cocaine, heroin) or behavioral addictions (e.g., gambling) with the aim of cessation or reduction of use and/or the amelioration of emotional, behavioral, interpersonal and other problems arising from the addictive behavior. Jon Howard Siegel, PH.D. NPI is 1124149513. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

6 STATE ST
SUITE 413
BANGOR, ME
ZIP 04401-112
Phone: (207) 942-2627
Fax: (207) 942-2627

The NPI 1124149513 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The enumeration date for this NPI number is 4/3/2007 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	103TA0400X	Psychologist	Addiction (Substance Use Disorder)			Yes
2	103TC0700X	Psychologist	Clinical	PS744	MAINE	X
3	103TC2200X	Psychologist	Clinical Child & Adolescent			X
4	103TF0000X	Psychologist	Family			X
5	103TF0200X	Psychologist	Forensic			X
6	103TP2701X	Psychologist	Group Psychotherapy			X

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	SI-MM3917	MEDICARE ID-TYPE UNSPECIFIED	MAINE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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