Provider Demographics
NPI:1265685804
Name:SIDMORE-SEYER, DENA STEPHANIE (MS, CRC, LCPC)
Entity Type:Individual
Prefix:MS
First Name:DENA
Middle Name:STEPHANIE
Last Name:SIDMORE-SEYER
Suffix:
Gender:F
Credentials:MS, CRC, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2615 MESA DR
Mailing Address - Street 2:
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52001-1668
Mailing Address - Country:US
Mailing Address - Phone:563-552-9211
Mailing Address - Fax:
Practice Address - Street 1:2615 MESA DR
Practice Address - Street 2:
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52001-1668
Practice Address - Country:US
Practice Address - Phone:563-552-9211
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-28
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
CACRC 00108799225C00000X
IL180.015569101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor