Healthcare Provider Details

I. General information

NPI: 1013156371
Provider Name (Legal Business Name): JOANNE CLARKE SEAWELL LPC/LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/10/2009
Last Update Date: 12/05/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6603 IRONGATE SQ
RICHMOND VA
23234-6081
US

IV. Provider business mailing address

13801 VILLAGE MILL DR SUITE 105
MIDLOTHIAN VA
23114-4382
US

V. Phone/Fax

Practice location:
  • Phone: 804-743-0960
  • Fax:
Mailing address:
  • Phone: 804-909-2803
  • Fax: 804-794-0838

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0701002369
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number0717000847
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: