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NPI Code Detail

MEDICARE: MS. ELIZABETH M SEELEY MSW

MEDICARE: MS. ELIZABETH M SEELEY MSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1205016227
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ELIZABETH M SEELEY MSW
Provider Business Mailing Address
First Line : 2514 N BROAD ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19132-4013
Country : US
Telephone Number : 215-599-2840
Fax Number : 215-599-1041
Provider Business Practice Location Address
First Line : 2514 N BROAD ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19132-4013
Country : US
Telephone Number : 215-599-2840
Fax Number : 215-599-1041
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/07/2007
Last Update Date : 11/07/2007

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