Provider Demographics
NPI:1225066558
Name:SEELAN, PATRICIA (LICSW)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:SEELAN
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:231 MAPLE ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05401-4562
Mailing Address - Country:US
Mailing Address - Phone:802-862-1509
Mailing Address - Fax:802-862-9339
Practice Address - Street 1:231 MAPLE ST
Practice Address - Street 2:SUITE 1
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05401-4562
Practice Address - Country:US
Practice Address - Phone:802-862-1509
Practice Address - Fax:802-862-9339
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT08900002691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT0VN0488Medicaid
VT0VN0488Medicare ID - Type Unspecified