Healthcare Provider Details

I. General information

NPI: 1326811126
Provider Name (Legal Business Name): VAISHNAVI SESHADRI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: VAISHNAVI SESHADRI LGPC

II. Dates (important events)

Enumeration Date: 11/02/2023
Last Update Date: 11/02/2023
Certification Date: 11/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10630 LITTLE PATUXENT PKWY STE 475
COLUMBIA MD
21044-6228
US

IV. Provider business mailing address

12 GARDENGATE CT
COLUMBUS NJ
08022-1971
US

V. Phone/Fax

Practice location:
  • Phone: 443-574-4295
  • Fax: 443-574-6515
Mailing address:
  • Phone: 732-395-9412
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLGP14544
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: