Provider Demographics
NPI:1083187579
Name:SEAL DWYER COUNSELING LLC
Entity Type:Organization
Organization Name:SEAL DWYER COUNSELING LLC
Other - Org Name:--NONE--
Other - Org Type:Other Name
Authorized Official - Title/Position:PRINCIPLE
Authorized Official - Prefix:
Authorized Official - First Name:SEAL
Authorized Official - Middle Name:SOPHIE
Authorized Official - Last Name:DWYER
Authorized Official - Suffix:
Authorized Official - Credentials:MS LMFT
Authorized Official - Phone:320-296-2530
Mailing Address - Street 1:528 7TH AVE N
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56303-3522
Mailing Address - Country:US
Mailing Address - Phone:320-296-2530
Mailing Address - Fax:
Practice Address - Street 1:601 W SAINT GERMAIN ST
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56301-3665
Practice Address - Country:US
Practice Address - Phone:320-296-2530
Practice Address - Fax:320-323-4387
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-07
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health