Provider Demographics
NPI:1851947964
Name:HORTON, SEBASTIAN GEORGE (LPC)
Entity Type:Individual
Prefix:MR
First Name:SEBASTIAN
Middle Name:GEORGE
Last Name:HORTON
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3661 W PANDION DR
Mailing Address - Street 2:
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83815-6004
Mailing Address - Country:US
Mailing Address - Phone:208-627-8866
Mailing Address - Fax:
Practice Address - Street 1:250 NORTHWEST BLVD STE 103
Practice Address - Street 2:
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814-2971
Practice Address - Country:US
Practice Address - Phone:208-889-4068
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-14
Last Update Date:2019-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional