Healthcare Provider Details

I. General information

NPI: 1134605785
Provider Name (Legal Business Name): SUSANNA-RACHEL SALOME SEAY PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/17/2018
Last Update Date: 09/22/2025
Certification Date: 09/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5424 W HIGHWAY 290 STE 108
AUSTIN TX
78735-8827
US

IV. Provider business mailing address

5424 W HIGHWAY 290 STE 108
AUSTIN TX
78735-8827
US

V. Phone/Fax

Practice location:
  • Phone: 512-430-1130
  • Fax: 512-677-6806
Mailing address:
  • Phone: 512-430-1130
  • Fax: 512-677-6806

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP138080
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: