Healthcare Provider Details

I. General information

NPI: 1952676322
Provider Name (Legal Business Name): CARLA CHRISTINE SEIPEL LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/18/2012
Last Update Date: 03/18/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2420 E 10TH ST
JEFFERSONVILLE IN
47130-7303
US

IV. Provider business mailing address

1119 DOEBROOK DR
NEW ALBANY IN
47150-2069
US

V. Phone/Fax

Practice location:
  • Phone: 812-282-8248
  • Fax:
Mailing address:
  • Phone: 812-945-5465
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number35001756A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: