Healthcare Provider Details

I. General information

NPI: 1043114168
Provider Name (Legal Business Name): SEANA LEE PERCY PMH-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2026
Last Update Date: 10/03/2026
Certification Date: 10/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

811 BLASIUS AVE
BRICK NJ
08724-2117
US

IV. Provider business mailing address

811 BLASIUS AVE
BRICK NJ
08724-2117
US

V. Phone/Fax

Practice location:
  • Phone: 732-606-3227
  • Fax:
Mailing address:
  • Phone: 732-606-3227
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: