Provider Demographics
NPI:1871926238
Name:SEAL, ELIZABETH K (MA; LMFT)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:K
Last Name:SEAL
Suffix:
Gender:F
Credentials:MA; LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1802 CALIFORNIA ST.
Mailing Address - Street 2:HUMBOLDT FAMILY SERVICE CENTER
Mailing Address - City:EUREKA
Mailing Address - State:CA
Mailing Address - Zip Code:95501
Mailing Address - Country:US
Mailing Address - Phone:707-443-7359
Mailing Address - Fax:707-443-1092
Practice Address - Street 1:1802 CALIFORNIA ST
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95501-2808
Practice Address - Country:US
Practice Address - Phone:707-443-7359
Practice Address - Fax:707-443-1092
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-20
Last Update Date:2022-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA107872106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist