Provider Demographics
NPI:1023043510
Name:SEYLER, ROBERT L (LICSW LADC)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:L
Last Name:SEYLER
Suffix:
Gender:M
Credentials:LICSW LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:236 PLEASANT ST
Mailing Address - Street 2:METHUEN EXECUTIVE PARK
Mailing Address - City:METHUEN
Mailing Address - State:MA
Mailing Address - Zip Code:01844-7135
Mailing Address - Country:US
Mailing Address - Phone:978-683-0133
Mailing Address - Fax:978-683-9818
Practice Address - Street 1:236 PLEASANT ST
Practice Address - Street 2:METHUEN EXECUTIVE PARK
Practice Address - City:METHUEN
Practice Address - State:MA
Practice Address - Zip Code:01844-7135
Practice Address - Country:US
Practice Address - Phone:978-683-0133
Practice Address - Fax:978-683-9818
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA167-LADC-1101YA0400X
MA1058721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAP03725Medicare ID - Type UnspecifiedBC/BS OF MASS