Provider Demographics
NPI:1083272876
Name:SEAVY, LYLE M (LCPC, NCC, CCMHC PHD)
Entity Type:Individual
Prefix:DR
First Name:LYLE
Middle Name:M
Last Name:SEAVY
Suffix:
Gender:M
Credentials:LCPC, NCC, CCMHC PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5560 MYSTIC MOON LN
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59106-3706
Mailing Address - Country:US
Mailing Address - Phone:406-671-9862
Mailing Address - Fax:
Practice Address - Street 1:5560 MYSTIC MOON LN
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59106-3706
Practice Address - Country:US
Practice Address - Phone:406-671-9862
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-05
Last Update Date:2019-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-LCPC-LIC-316101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional