Healthcare Provider Details

I. General information

NPI: 1609537760
Provider Name (Legal Business Name): JOBY SEITZ
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/31/2021
Last Update Date: 12/31/2021
Certification Date: 12/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1810 HAYES ST
NASHVILLE TN
37203-2504
US

IV. Provider business mailing address

2228 SCOTT AVE
NASHVILLE TN
37216-3815
US

V. Phone/Fax

Practice location:
  • Phone: 615-321-0005
  • Fax:
Mailing address:
  • Phone: 314-412-2562
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: