Provider Demographics
NPI:1508087040
Name:SEAKS, KRISTIN TURINE (LSW)
Entity Type:Individual
Prefix:MRS
First Name:KRISTIN
Middle Name:TURINE
Last Name:SEAKS
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:MS
Other - First Name:KRISTIN
Other - Middle Name:TURINE
Other - Last Name:MIKKELSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LSW
Mailing Address - Street 1:135 SIMS ST
Mailing Address - Street 2:SUITE 204
Mailing Address - City:DICKINSON
Mailing Address - State:ND
Mailing Address - Zip Code:58601-5148
Mailing Address - Country:US
Mailing Address - Phone:701-225-3310
Mailing Address - Fax:701-225-2208
Practice Address - Street 1:135 SIMS ST
Practice Address - Street 2:SUITE 204
Practice Address - City:DICKINSON
Practice Address - State:ND
Practice Address - Zip Code:58601-5148
Practice Address - Country:US
Practice Address - Phone:701-225-3310
Practice Address - Fax:701-225-2208
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND2950104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker