Provider Demographics
NPI:1326497264
Name:SEELINGER, BLAIR BRENNA (M ED, LPCA, LMFTA)
Entity Type:Individual
Prefix:
First Name:BLAIR
Middle Name:BRENNA
Last Name:SEELINGER
Suffix:
Gender:F
Credentials:M ED, LPCA, LMFTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:848 N TAYLOR ST
Mailing Address - Street 2:
Mailing Address - City:WAKE FOREST
Mailing Address - State:NC
Mailing Address - Zip Code:27587-2239
Mailing Address - Country:US
Mailing Address - Phone:443-880-5513
Mailing Address - Fax:
Practice Address - Street 1:848 N TAYLOR ST
Practice Address - Street 2:
Practice Address - City:WAKE FOREST
Practice Address - State:NC
Practice Address - Zip Code:27587-2239
Practice Address - Country:US
Practice Address - Phone:443-880-5513
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-10
Last Update Date:2016-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA11939101YM0800X
NC11039A106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist