Provider Demographics
NPI:1235241761
Name:SEELBACH, MARY HENDY (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:HENDY
Last Name:SEELBACH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:312 CRILLON DR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-2606
Mailing Address - Country:US
Mailing Address - Phone:859-351-5166
Mailing Address - Fax:859-278-0802
Practice Address - Street 1:1517 NICHOLASVILLE RD STE 302
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-1429
Practice Address - Country:US
Practice Address - Phone:859-351-5166
Practice Address - Fax:859-278-0802
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY09691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical