Healthcare Provider Details

I. General information

NPI: 1528300902
Provider Name (Legal Business Name): SEALY MENTAL HEALTH COUNSELING SERVICE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2013
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28490 AVENUE STANFORD STE 140
SANTA CLARITA CA
91355-0921
US

IV. Provider business mailing address

28490 AVENUE STANFORD STE 140
SANTA CLARITA CA
91355-0921
US

V. Phone/Fax

Practice location:
  • Phone: 661-383-9561
  • Fax: 661-383-9556
Mailing address:
  • Phone: 661-651-8596
  • Fax: 661-383-9556

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: DR. AUGUSTUS C SEALY
Title or Position: MANAGER
Credential: PH.D,LMHC
Phone: 661-651-8596