Provider Demographics
NPI:1942408547
Name:SEEHAUS, MAVIS (LCSW)
Entity Type:Individual
Prefix:MS
First Name:MAVIS
Middle Name:
Last Name:SEEHAUS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 E 95TH ST
Mailing Address - Street 2:APT. # 5M
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-4000
Mailing Address - Country:US
Mailing Address - Phone:212-876-6635
Mailing Address - Fax:
Practice Address - Street 1:225 E 95TH ST
Practice Address - Street 2:APT. # 5M
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-4000
Practice Address - Country:US
Practice Address - Phone:212-876-6635
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-05
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR048178-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical