Provider Demographics
NPI:1205491032
Name:SIEGEL, DARIA (LPCA, MS)
Entity type:Individual
Prefix:
First Name:DARIA
Middle Name:
Last Name:SIEGEL
Suffix:
Gender:F
Credentials:LPCA, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 SHADOWOOD DR APT X
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-2410
Mailing Address - Country:US
Mailing Address - Phone:704-724-1097
Mailing Address - Fax:
Practice Address - Street 1:1915 CHAPEL HILL RD STE A
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-1177
Practice Address - Country:US
Practice Address - Phone:919-246-5664
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-07
Last Update Date:2019-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA14224101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health