MEDICARE: MR. CHRISTOPHER GLEN SEALS MS, LPC, LCDC, NCC

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
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	16031	TX
2	101YP2500X	Professional Counselor	87819	TX

General Provider Information

NPI Number	:	1225780703
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CHRISTOPHER GLEN SEALS MS, LPC, LCDC, NCC

Provider Business Mailing Address
First Line	:	539 W COMMERCE ST # 2613
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75208-1953
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4004 WORTH ST
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75246-1607
Country	:	US
Telephone Number	:	214-623-6830
Fax Number	:	214-623-6807

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/25/2022
Last Update Date	:	10/13/2023

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Directions to “ MR. CHRISTOPHER GLEN SEALS MS, LPC, LCDC, NCC” Practice Location

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