Provider Demographics
NPI:1417308487
Name:SEIM, CHRISTINA MARIE RUST (MSW)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:MARIE RUST
Last Name:SEIM
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:CHRISTINA
Other - Middle Name:MARIE
Other - Last Name:RUST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:555 STOCKTON ST
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32204-2534
Mailing Address - Country:US
Mailing Address - Phone:904-387-4661
Mailing Address - Fax:904-389-8578
Practice Address - Street 1:555 STOCKTON ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32204-2534
Practice Address - Country:US
Practice Address - Phone:904-387-4661
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-30
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW15754101YM0800X
1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health