Provider Demographics
NPI:1033868146
Name:SEELER, COURTNEY (BS, CADAC II)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:SEELER
Suffix:
Gender:F
Credentials:BS, CADAC II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 MOCCASIN TRL
Mailing Address - Street 2:
Mailing Address - City:KOKOMO
Mailing Address - State:IN
Mailing Address - Zip Code:46902-5489
Mailing Address - Country:US
Mailing Address - Phone:765-669-0795
Mailing Address - Fax:
Practice Address - Street 1:3423 S LAFOUNTAIN ST STE C
Practice Address - Street 2:
Practice Address - City:KOKOMO
Practice Address - State:IN
Practice Address - Zip Code:46902-3857
Practice Address - Country:US
Practice Address - Phone:765-286-5773
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-23
Last Update Date:2022-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INC2-51268101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)