Provider Demographics
NPI:1609016153
Name:CURRAN SEELEY
Entity Type:Organization
Organization Name:CURRAN SEELEY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SUPERVISOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MANI
Authorized Official - Middle Name:
Authorized Official - Last Name:FAEZ
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:307-733-3908
Mailing Address - Street 1:PO BOX 11390
Mailing Address - Street 2:610 WEST BROADWAY SUITE L1
Mailing Address - City:JACKSON
Mailing Address - State:WY
Mailing Address - Zip Code:83002-1390
Mailing Address - Country:US
Mailing Address - Phone:307-733-3908
Mailing Address - Fax:307-734-0017
Practice Address - Street 1:610 WEST BROADWAY SUITE L1
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:WY
Practice Address - Zip Code:83002-1390
Practice Address - Country:US
Practice Address - Phone:307-733-3908
Practice Address - Fax:307-734-0017
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-24
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY384104100000X
106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty