Provider Demographics
NPI:1790197572
Name:SEALS, EUGENE HARRISON JR (MA, LPA)
Entity Type:Individual
Prefix:MR
First Name:EUGENE
Middle Name:HARRISON
Last Name:SEALS
Suffix:JR
Gender:M
Credentials:MA, LPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2692
Mailing Address - Street 2:
Mailing Address - City:MORGANTON
Mailing Address - State:NC
Mailing Address - Zip Code:28680-2692
Mailing Address - Country:US
Mailing Address - Phone:828-460-7511
Mailing Address - Fax:828-584-2043
Practice Address - Street 1:3619 SEALS ROAD
Practice Address - Street 2:
Practice Address - City:MORGANTON
Practice Address - State:NC
Practice Address - Zip Code:28655
Practice Address - Country:US
Practice Address - Phone:828-584-2043
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-28
Last Update Date:2014-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLPA 696103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist