Provider Demographics
NPI:1003276643
Name:SEISS, LLC
Entity Type:Organization
Organization Name:SEISS, LLC
Other - Org Name:OAKTREE GUIDANCE & WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNY
Authorized Official - Middle Name:
Authorized Official - Last Name:SEISS
Authorized Official - Suffix:
Authorized Official - Credentials:PSY D, HSPP
Authorized Official - Phone:260-750-6461
Mailing Address - Street 1:119 W. TENTH ST
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:IN
Mailing Address - Zip Code:46706-2230
Mailing Address - Country:US
Mailing Address - Phone:260-570-4515
Mailing Address - Fax:260-209-0762
Practice Address - Street 1:9910 DUPONT CIRCLE DRIVE
Practice Address - Street 2:SUITE 140
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46825
Practice Address - Country:US
Practice Address - Phone:260-570-4515
Practice Address - Fax:260-209-0762
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-24
Last Update Date:2016-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN20042462A103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty