Provider Demographics
NPI:1235854928
Name:SELIGMAN, SKYLAR
Entity Type:Individual
Prefix:
First Name:SKYLAR
Middle Name:
Last Name:SELIGMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 FOREST RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:ROWLEY
Mailing Address - State:MA
Mailing Address - Zip Code:01969-2147
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:49 HALE ST APT 3
Practice Address - Street 2:
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-4773
Practice Address - Country:US
Practice Address - Phone:978-810-6752
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-05
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAJ016181601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical