Provider Demographics
NPI:1245784602
Name:SEASE, SARAH ELIZABETH (MED, PSYD)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:ELIZABETH
Last Name:SEASE
Suffix:
Gender:F
Credentials:MED, PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1606 CLIFTON PARK CIR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19802-1811
Mailing Address - Country:US
Mailing Address - Phone:803-671-4594
Mailing Address - Fax:
Practice Address - Street 1:1606 CLIFTON PARK CIR
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19802-1811
Practice Address - Country:US
Practice Address - Phone:803-671-4594
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-15
Last Update Date:2016-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEB2-0000361OtherPSYCHOLOGICAL ASSISTANT