Provider Demographics
NPI:1871905026
Name:REBECCA SEITZ LCSW, LLC
Entity type:Organization
Organization Name:REBECCA SEITZ LCSW, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:SEITZ
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:573-544-4023
Mailing Address - Street 1:301 COURT ST
Mailing Address - Street 2:PO BOX 104
Mailing Address - City:FULTON
Mailing Address - State:MO
Mailing Address - Zip Code:65251-7900
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2625 FAIRWAY DR
Practice Address - Street 2:
Practice Address - City:FULTON
Practice Address - State:MO
Practice Address - Zip Code:65251-4023
Practice Address - Country:US
Practice Address - Phone:573-544-4023
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-22
Last Update Date:2014-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0033471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty