Healthcare Provider Details

I. General information

NPI: 1750448965
Provider Name (Legal Business Name): AUGUSTUS C SEALY PHD LMHC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/03/2007
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
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: 661-651-8596
  • Fax: 661-383-9556
Mailing address:
  • Phone: 661-651-8596
  • Fax: 661-383-9556

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number002185
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number3864
License Number StateMA
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number14957
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: