MEDICARE: ALLEN SEAQUIST MA, LPCC

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	101YM0800X	Mental Health Counselor	CC05017	MN

General Provider Information

NPI Number	:	1679460208
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALLEN SEAQUIST MA, LPCC

Provider Business Mailing Address
First Line	:	2095 PALACE AVE
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55105-1330
Country	:	US
Telephone Number	:	952-367-9532
Fax Number	:

Provider Business Practice Location Address
First Line	:	10077 DOGWOOD ST NW STE 202
Second Line	:
City	:	COON RAPIDS
State	:	MN
Zip	:	55448-5286
Country	:	US
Telephone Number	:	952-367-9532
Fax Number	:

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

Provider Enumeration Date	:	06/18/2025
Last Update Date	:	06/18/2025

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