Provider Demographics
NPI:1578240107
Name:MARAIS, SEUGNET (MA ,LMFTA)
Entity Type:Individual
Prefix:
First Name:SEUGNET
Middle Name:
Last Name:MARAIS
Suffix:
Gender:F
Credentials:MA ,LMFTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7745 BALLANTYNE COMMONS PKWY STE 102
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-5056
Mailing Address - Country:US
Mailing Address - Phone:704-995-0342
Mailing Address - Fax:704-943-0707
Practice Address - Street 1:7745 BALLANTYNE COMMONS PKWY STE 102
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-5056
Practice Address - Country:US
Practice Address - Phone:704-995-0342
Practice Address - Fax:704-943-0707
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-05
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12530A106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC12530AOtherLMFTA