Provider Demographics
NPI:1417665183
Name:SEALS, EFFIE REGINA (PLPC)
Entity Type:Individual
Prefix:
First Name:EFFIE
Middle Name:REGINA
Last Name:SEALS
Suffix:
Gender:F
Credentials:PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3015 HIGHWAY 956
Mailing Address - Street 2:
Mailing Address - City:ETHEL
Mailing Address - State:LA
Mailing Address - Zip Code:70730-4520
Mailing Address - Country:US
Mailing Address - Phone:225-681-8934
Mailing Address - Fax:
Practice Address - Street 1:3015 HIGHWAY 956
Practice Address - Street 2:
Practice Address - City:ETHEL
Practice Address - State:LA
Practice Address - Zip Code:70730-4520
Practice Address - Country:US
Practice Address - Phone:804-681-8934
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-10
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPLC9147101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)