Provider Demographics
NPI:1942416847
Name:SEWARD, THERESA MARIE (MA, LPC)
Entity Type:Individual
Prefix:MRS
First Name:THERESA
Middle Name:MARIE
Last Name:SEWARD
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12301 W BELL RD
Mailing Address - Street 2:SUITE A102
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85378-9705
Mailing Address - Country:US
Mailing Address - Phone:623-330-1099
Mailing Address - Fax:623-583-3888
Practice Address - Street 1:12301 W BELL RD
Practice Address - Street 2:SUITE A102
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85378-9705
Practice Address - Country:US
Practice Address - Phone:623-330-1099
Practice Address - Fax:623-583-3888
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-10623101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional