Provider Demographics
NPI:1083160303
Name:SEAMON, GRACE ELIZABETH (MS, LMFTA)
Entity Type:Individual
Prefix:
First Name:GRACE
Middle Name:ELIZABETH
Last Name:SEAMON
Suffix:
Gender:F
Credentials:MS, LMFTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3332 BRIDGES ST
Mailing Address - Street 2:SUITE 3A
Mailing Address - City:MOREHEAD CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28557-3280
Mailing Address - Country:US
Mailing Address - Phone:888-557-1675
Mailing Address - Fax:888-557-1675
Practice Address - Street 1:8101 C EMERALD ISLE DR.
Practice Address - Street 2:
Practice Address - City:EMERALD ISLE
Practice Address - State:NC
Practice Address - Zip Code:28594
Practice Address - Country:US
Practice Address - Phone:888-557-1675
Practice Address - Fax:888-557-1675
Is Sole Proprietor?:No
Enumeration Date:2016-08-28
Last Update Date:2016-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11070A106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist