Provider Demographics
NPI:1669488409
Name:SEYLER, LOUIS SHEPHERD (LCSW)
Entity Type:Individual
Prefix:MR
First Name:LOUIS
Middle Name:SHEPHERD
Last Name:SEYLER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:703 THIMBLE SHOALS BLVD.
Mailing Address - Street 2:SUITE A-3
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606
Mailing Address - Country:US
Mailing Address - Phone:757-873-3401
Mailing Address - Fax:757-223-1165
Practice Address - Street 1:703 THIMBLE SHOALS BLVD.
Practice Address - Street 2:SUITE A-3
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606
Practice Address - Country:US
Practice Address - Phone:757-873-3401
Practice Address - Fax:757-223-1165
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2009-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040002501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA092756OtherBCBS
VA541493432OtherWORK COMP
VA082343OtherSENTARA
VACHAMPUSOther541493432
VA127099000OtherMAGELLAN BEHAVORAL
VA541493432OtherAETNA
VA541493432OtherVHN
VA541493432OtherCOMMERICAL
VA541493432OtherCIGNA
VA177152OtherMANAGED HEALTH
VA008909172Medicaid
VA092756OtherBCBS FEP
VA541493432OtherMAMSI
VA541493432OtherDEPT OF REHAB
ND541493432OtherBCBS
VA541493432OtherAETNA
VA008909172Medicaid