Healthcare Provider Details

I. General information

NPI: 1699552588
Provider Name (Legal Business Name): GWENDOLYN H. SEILER LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: GWEN SEILER LPC

II. Dates (important events)

Enumeration Date: 09/13/2023
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1443 CROSSINGS CENTER DR STE A
FOREST VA
24551-5081
US

IV. Provider business mailing address

414 MT HAVEN DR
FOREST VA
24551-2108
US

V. Phone/Fax

Practice location:
  • Phone: 434-219-5621
  • Fax:
Mailing address:
  • Phone: 804-399-4634
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0701012856
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: