Provider Demographics
NPI:1326811126
Name:SESHADRI, VAISHNAVI
Entity Type:Individual
Prefix:
First Name:VAISHNAVI
Middle Name:
Last Name:SESHADRI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:VAISHNAVI
Other - Middle Name:
Other - Last Name:SESHADRI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LGPC
Mailing Address - Street 1:12 GARDENGATE CT
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:NJ
Mailing Address - Zip Code:08022-1971
Mailing Address - Country:US
Mailing Address - Phone:732-395-9412
Mailing Address - Fax:
Practice Address - Street 1:10630 LITTLE PATUXENT PKWY STE 475
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-6228
Practice Address - Country:US
Practice Address - Phone:443-574-4295
Practice Address - Fax:443-574-6515
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-02
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP14544101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional