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General NPI Number Information
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NPI Number | 1912102526
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Entity Type | Individual
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Provider Name | KENNETH L. SEEL CADC, LLMFT
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Gender | Male
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Dates
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Enumeration Date | 06/15/2007
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Last Update Date | 04/25/2012
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Provider Practice Location Address
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Address Line | 409 W WASHINGTON AVE
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City | JACKSON
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State | MI
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Zip | 49201-2168
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Country | US
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Telephone | 925-818-4419
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Fax |
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Provider Business Mailing Address
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Address Line | 409 W WASHINGTON AVE
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City | JACKSON
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State | MI
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Zip | 49201-2168
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Country | US
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Telephone | 925-818-4419
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | S0606201414
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 4101006510
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License Number State | MI
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