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General NPI Number Information
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NPI Number | 1982949392
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Entity Type | Individual
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Provider Name | NICOLE M. SEITZ LPC (PA) LPCC NM)
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Gender | Female
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Dates
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Enumeration Date | 12/11/2012
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Last Update Date | 03/19/2024
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Provider Practice Location Address
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Address Line | 313 S 16TH ST
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City | PHILADELPHIA
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State | PA
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Zip | 19102-4908
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Country | US
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Telephone | 267-971-5729
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Fax |
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Provider Business Mailing Address
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Address Line | 100 W 19TH ST
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City | SILVER CITY
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State | NM
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Zip | 88061-5605
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Country | US
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Telephone | 267-971-5729
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | PC006500
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | CCMH0175511
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License Number State | NM
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