1467728287 NPI number — MR. ANTHONY EUGENE SEAMSTER LPC, NCC, LLC

Table of content: MR. ANTHONY EUGENE SEAMSTER LPC, NCC, LLC (NPI 1467728287)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467728287 NPI number — MR. ANTHONY EUGENE SEAMSTER LPC, NCC, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SEAMSTER
Provider First Name:
ANTHONY
Provider Middle Name:
EUGENE
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
LPC, NCC, LLC
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1467728287
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/01/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
713 LEMOYNE DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LA PLACE
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70068-2046
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
504-994-1964
Provider Business Mailing Address Fax Number:
504-304-4800

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3945 N I 10 SERVICE RD W STE 100A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
METAIRIE
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70002-6881
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
504-994-1964
Provider Business Practice Location Address Fax Number:
504-304-4800
Provider Enumeration Date:
03/26/2012

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X , with the licence number:  4442 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 601016261 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".




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