Healthcare Provider Details

I. General information

NPI: 1477101830
Provider Name (Legal Business Name): SETH ROBERT ROLLINS LPCC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2019
Last Update Date: 08/19/2025
Certification Date: 08/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1229 LINCOLN HWY
VAN WERT OH
45891-1877
US

IV. Provider business mailing address

1229 LINCOLN HWY
VAN WERT OH
45891-1877
US

V. Phone/Fax

Practice location:
  • Phone: 419-238-1695
  • Fax:
Mailing address:
  • Phone: 419-238-1695
  • Fax: 419-238-1007

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberE.2404113
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberE.2404113
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: