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General NPI Number Information
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NPI Number | 1467898296
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Entity Type | Organization
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Legal Business Name | CHARLENE M SEAL, LCSW, LLC
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Dates
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Enumeration Date | 05/20/2013
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Last Update Date | 05/20/2013
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Provider Practice Location Address
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Address Line | 2 PEAR ST
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City | ROME
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State | GA
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Zip | 30161-1711
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Country | US
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Telephone | 706-936-9440
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Fax |
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Provider Business Mailing Address
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Address Line | 8 E 4TH AVE SUITE 100
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City | ROME
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State | GA
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Zip | 30161-3134
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Country | US
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Telephone | 706-237-8375
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. CHARLENE M SEAL
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Credential | LCSW
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Telephone | 706-237-8375
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CSW002789
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License Number State | GA
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