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Madisen Avery Siegel

Marriage & Family Therapist

Behavioral Health & Social Service Providers

1081 Westwood Blvd Ste 234, Los Angeles, CA 90024-2931

PECOS Enrollment

This provider is enrolled in PECOS as MADISEN SIEGEL.

Based on the most recent information from CMS, provider Madisen Avery Siegel is legally eligible to order and refer claims for Part B and DME services only.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1881172070
Provider Type
Individual
Full Name
Siegel, Madisen Avery
Gender
Female

Sole Proprietor
No
Enumeration Date
7/31/2018
Last Updated
7/25/2019

Contact Information

Practice Location

1081 Westwood Blvd Ste 234, Los Angeles, CA 90024-2931

(310) 713-2890

Unlisted Fax

Mailing Location

1081 Westwood Blvd Ste 234, Los Angeles, CA 90024-2931

(310) 713-2890

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 106H00000X Primary	Description Marriage & Family Therapist Behavioral Health & Social Service Providers	License 114566 California
Code 106H00000X	Description Marriage & Family Therapist Behavioral Health & Social Service Providers	License AMFT95510 California
Code 106H00000X	Description Marriage & Family Therapist Behavioral Health & Social Service Providers	License MFT114566 California

Madisen Avery Siegel

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

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