MEDICARE: MATTHEW SEGER LMHCA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor	MC61540903	WA
2	101YM0800X	Mental Health Counselor	MC61540903	WA

General Provider Information

NPI Number	:	1326873902
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MATTHEW SEGER LMHCA

Provider Business Mailing Address
First Line	:	25 E WASHINGTON ST STE 1458
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60602-1856
Country	:	US
Telephone Number	:	872-216-2843
Fax Number	:

Provider Business Practice Location Address
First Line	:	25 E WASHINGTON ST STE 1458
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60602-1856
Country	:	US
Telephone Number	:	872-216-2843
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/04/2024
Last Update Date	:	09/04/2024

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