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1750448965 NPI number — AUGUSTUS C SEALY PHD LMHC

NPI Number: 1750448965
Health Care Provider/Practitioner: AUGUSTUS C SEALY PHD LMHC

Information about “1750448965” NPI (AUGUSTUS C SEALY PHD LMHC) exists in 1750448965 in HTML format HTML  |  1750448965 in plain Text format TXT  |  1750448965 in PDF (Portable Document Format) PDF  |  1750448965 in an XML format XML  formats.

NPI Number : 1750448965 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1750448965",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "SEALY",
    "FirstName": "AUGUSTUS",
    "MiddleName": "C",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "PHD LMHC",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "20000 PLUM CANYON RD UNIT 1815",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "SANTA CLARITA",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "91350-2416",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "661-651-8596",
    "MailingAddressFaxNumber": "661-360-9453",
    "FirstLinePracticeLocationAddress": "370 MAIN ST STE 910",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "WORCESTER",
    "PracticeLocationAddressStateName": "MA",
    "PracticeLocationAddressPostalCode": "01608-1723",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "661-651-8596",
    "PracticeLocationAddressFaxNumber": "661-360-9453",
    "EnumerationDate": "01/03/2007",
    "LastUpdateDate": "12/21/2024",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "101YM0800X",
        "TaxonomyName": "Mental Health Counselor",
        "LicenseNumber": "3864",
        "LicenseNumberStateCode": "MA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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