Provider Demographics
NPI:1689635849
Name:SEAMAN, RICHARD KENNETH (MED)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:KENNETH
Last Name:SEAMAN
Suffix:
Gender:M
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 EAST 26 TH STREET
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57103-6464
Mailing Address - Country:US
Mailing Address - Phone:605-339-6949
Mailing Address - Fax:605-330-0338
Practice Address - Street 1:2900 E 26TH ST
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57103-4058
Practice Address - Country:US
Practice Address - Phone:605-339-6949
Practice Address - Fax:605-330-0338
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-29
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDLMFT1066101Y00000X
SDLPC 516101YP2500X
SDLCSW 376104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD46 040 8747Medicare UPIN
SDS40162Medicare ID - Type Unspecified