Provider Demographics
NPI:1417457680
Name:ELIZABETH SEAU LCSW
Entity Type:Organization
Organization Name:ELIZABETH SEAU LCSW
Other - Org Name:ELIZABETH SEAU
Other - Org Type:Doing Business As
Authorized Official - Title/Position:LICENCED CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:C
Authorized Official - Last Name:SEAU
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:505-977-6585
Mailing Address - Street 1:600 CENTRAL AVE STE 407
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59401-3143
Mailing Address - Country:US
Mailing Address - Phone:505-977-6585
Mailing Address - Fax:
Practice Address - Street 1:600 CENTRAL AVE STE 407
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59401
Practice Address - Country:US
Practice Address - Phone:505-977-6585
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-14
Last Update Date:2018-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-LCSW-LIC-297061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty