Provider Demographics
NPI:1477691517
Name:SEYMOUR, WILLIAM GREGORY (LPC-MHSP)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:GREGORY
Last Name:SEYMOUR
Suffix:
Gender:M
Credentials:LPC-MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:933 SIGNAL RD.
Mailing Address - Street 2:
Mailing Address - City:SIGNAL MOUNTAIN
Mailing Address - State:TN
Mailing Address - Zip Code:37343
Mailing Address - Country:US
Mailing Address - Phone:423-315-2264
Mailing Address - Fax:
Practice Address - Street 1:5726 MARLIN RD
Practice Address - Street 2:FRANKLIN BUILDING, SUITE 6
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37411
Practice Address - Country:US
Practice Address - Phone:423-954-8890
Practice Address - Fax:423-954-8880
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1932101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional