1376851675 NPI number — ANDREW E. SEGUEL MS, LPC, LCMHC

Table of content: (NPI 1588680649)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1376851675 NPI number — ANDREW E. SEGUEL MS, LPC, LCMHC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SEGUEL
Provider First Name:
ANDREW
Provider Middle Name:
E.
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MS, LPC, LCMHC
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:
1376851675
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/28/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
22 PINNACLE RDG
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
UNDERHILL
Provider Business Mailing Address State Name:
VT
Provider Business Mailing Address Postal Code:
05489-4411
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
973-980-5123
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
22 PINNACLE RDG
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
UNDERHILL
Provider Business Practice Location Address State Name:
VT
Provider Business Practice Location Address Postal Code:
05489-4411
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
318-523-0523
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/21/2010

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: 101Y00000X , with the licence number:  37PC00611600 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101Y00000X , with the licence number: 068.0134602 , registered in the state of VT ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YM0800X , with the licence number: 068.0134602 , registered in the state of VT ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YM0800X , with the licence number: 37PC00611600 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YP2500X , with the licence number: 068.0134602 , registered in the state of VT ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YP2500X , with the licence number: 37PC00611600 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 527486 . This is a "AGENCY PROVIDER NUMBER" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 0023701 . This is a "AGENCY PROVIDER NUMBER" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 7794703 . This is a "AGENCY PROVIDER NUMBER FOR PROGRAM" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".