MEDICARE: LEANNE SEGUIN, LLC

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	103TC0700X	Clinical Psychologist

General Provider Information

NPI Number	:	1922486018
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LEANNE SEGUIN, LLC

Provider Business Mailing Address
First Line	:	710 N LEMON AVE UNIT 359
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34236-4297
Country	:	US
Telephone Number	:	970-657-0094
Fax Number	:

Provider Business Practice Location Address
First Line	:	710 N LEMON AVE UNIT 359
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34236-4297
Country	:	US
Telephone Number	:	970-657-0094
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JUDY LEANNE SEGUIN
Credential	:
Telephone Number	:	970-657-0094

Provider Enumeration Date	:	05/11/2015
Last Update Date	:	01/28/2026

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