Provider Demographics
NPI:1902908601
Name:SIGMAN-YOUNG, LOIS EVE (MSW)
Entity Type:Individual
Prefix:MS
First Name:LOIS
Middle Name:EVE
Last Name:SIGMAN-YOUNG
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:381 HUBBARD ST
Mailing Address - Street 2:
Mailing Address - City:GLASTONBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06033-2063
Mailing Address - Country:US
Mailing Address - Phone:860-659-4431
Mailing Address - Fax:860-267-0310
Practice Address - Street 1:381 HUBBARD ST
Practice Address - Street 2:
Practice Address - City:GLASTONBURY
Practice Address - State:CT
Practice Address - Zip Code:06033-2063
Practice Address - Country:US
Practice Address - Phone:860-659-4431
Practice Address - Fax:860-267-0310
Is Sole Proprietor?:No
Enumeration Date:2006-09-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0004411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
6217353OtherUBH
CT004256667Medicaid
134298OtherVALUE OPTIONS
267328000OtherMAGELLAN
079578OtherMHN
P1585756OtherOXFORD
800000188Medicare ID - Type Unspecified