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NPI Code Detail

MEDICARE: MS. STEPHANIE D. SEATON

MEDICARE: MS. STEPHANIE D. SEATON
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
11041C0700XClinical Social Worker
21041C0700XClinical Social Worker149.015602IL

General Provider Information

NPI Number : 1548453277
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. STEPHANIE D. SEATON
Provider Business Mailing Address
First Line : 112 DERBYSHIRE DR
Second Line :
City : SWANSEA
State : IL
Zip : 62226-3034
Country : US
Telephone Number : 618-263-2967
Fax Number :
Provider Business Practice Location Address
First Line : 50 NORTHGATE INDUSTRIAL DR
Second Line :
City : GRANITE CITY
State : IL
Zip : 62040-6805
Country : US
Telephone Number : 618-877-4420
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/27/2007
Last Update Date : 12/27/2012

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