Provider Demographics
NPI:1497212336
Name:SEADER, TONIA (CADC-R, QMHA-I)
Entity Type:Individual
Prefix:
First Name:TONIA
Middle Name:
Last Name:SEADER
Suffix:
Gender:F
Credentials:CADC-R, QMHA-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 S 5TH ST
Mailing Address - Street 2:
Mailing Address - City:COTTAGE GROVE
Mailing Address - State:OR
Mailing Address - Zip Code:97424-2008
Mailing Address - Country:US
Mailing Address - Phone:541-767-4260
Mailing Address - Fax:541-684-4156
Practice Address - Street 1:75 S 5TH ST
Practice Address - Street 2:
Practice Address - City:COTTAGE GROVE
Practice Address - State:OR
Practice Address - Zip Code:97424-2008
Practice Address - Country:US
Practice Address - Phone:541-767-4260
Practice Address - Fax:541-684-4156
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-27
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR20-12-10006101YA0400X
OR19-QMHA-1-02279101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health