Healthcare Provider Details

I. General information

NPI: 1316864127
Provider Name (Legal Business Name): STEPHANIE SEATON MED
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2026
Last Update Date: 07/01/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3704 PACIFIC AVE STE 300
VIRGINIA BEACH VA
23451-2719
US

IV. Provider business mailing address

1403 LAKE HURON DR
VIRGINIA BEACH VA
23464-6464
US

V. Phone/Fax

Practice location:
  • Phone: 757-660-8293
  • Fax:
Mailing address:
  • Phone: 757-660-8293
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0704018961
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: