Provider Demographics
NPI:1790868362
Name:SEAMON, RHONDA JEAN (LCSW)
Entity Type:Individual
Prefix:
First Name:RHONDA
Middle Name:JEAN
Last Name:SEAMON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:RHONDA
Other - Middle Name:JEAN
Other - Last Name:CUDO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:RR 1 BOX 153
Mailing Address - Street 2:
Mailing Address - City:NEW ALBANY
Mailing Address - State:PA
Mailing Address - Zip Code:18833-9757
Mailing Address - Country:US
Mailing Address - Phone:570-928-7613
Mailing Address - Fax:
Practice Address - Street 1:21 MAIN ST
Practice Address - Street 2:
Practice Address - City:TOWANDA
Practice Address - State:PA
Practice Address - Zip Code:18848-1803
Practice Address - Country:US
Practice Address - Phone:570-265-2525
Practice Address - Fax:570-265-1075
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACAC 0555101YA0400X
PACWO145681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
047066Medicare ID - Type Unspecified