Provider Demographics
NPI:1447300595
Name:SEGUIN, SCOTT W (LCAS, LPC)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:W
Last Name:SEGUIN
Suffix:
Gender:M
Credentials:LCAS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 PEE DEE AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:ALBEMARLE
Mailing Address - State:NC
Mailing Address - Zip Code:28001-4932
Mailing Address - Country:US
Mailing Address - Phone:704-986-1500
Mailing Address - Fax:866-404-5622
Practice Address - Street 1:1001 NAVAHO DR
Practice Address - Street 2:SUITE 100
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-7335
Practice Address - Country:US
Practice Address - Phone:919-856-4703
Practice Address - Fax:919-856-3795
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2016-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1127101YA0400X
NC7156101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional