Provider Demographics
NPI:1184650806
Name:SEYKOWSKI, DONNA GWENDOLYNN (LPC)
Entity Type:Individual
Prefix:MS
First Name:DONNA
Middle Name:GWENDOLYNN
Last Name:SEYKOWSKI
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:WENDY
Other - Middle Name:
Other - Last Name:SEYKOWSKI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA, LPC
Mailing Address - Street 1:PO BOX 3624
Mailing Address - Street 2:
Mailing Address - City:MORGANTON
Mailing Address - State:NC
Mailing Address - Zip Code:28680-3624
Mailing Address - Country:US
Mailing Address - Phone:828-439-8191
Mailing Address - Fax:828-439-2588
Practice Address - Street 1:207 QUEEN ST
Practice Address - Street 2:
Practice Address - City:MORGANTON
Practice Address - State:NC
Practice Address - Zip Code:28655-3341
Practice Address - Country:US
Practice Address - Phone:828-439-8191
Practice Address - Fax:828-225-4822
Is Sole Proprietor?:No
Enumeration Date:2006-06-24
Last Update Date:2019-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4952101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC140UCOtherBCBSNC GRP # 015HF
NC6102702Medicaid