Provider Demographics
NPI:1174030167
Name:SEGUIN, THOMAS CLIFFORD (MA)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:CLIFFORD
Last Name:SEGUIN
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2923 BLACKHAWK DR
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:NE
Mailing Address - Zip Code:68123-3709
Mailing Address - Country:US
Mailing Address - Phone:402-965-1146
Mailing Address - Fax:
Practice Address - Street 1:1001 S 70TH ST STE 225
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510-7906
Practice Address - Country:US
Practice Address - Phone:402-325-0117
Practice Address - Fax:402-817-3681
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-29
Last Update Date:2019-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2322101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health