Provider Demographics
NPI:1184604423
Name:SEEGMILLER, ALAN CARROLL (LCSW)
Entity type:Individual
Prefix:MR
First Name:ALAN
Middle Name:CARROLL
Last Name:SEEGMILLER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:MR
Other - First Name:ALAN
Other - Middle Name:C
Other - Last Name:SEEGMILLER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:443 SOUTH 600 EAST
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84102
Mailing Address - Country:US
Mailing Address - Phone:801-538-2057
Mailing Address - Fax:
Practice Address - Street 1:443 S 600 E
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84102-2708
Practice Address - Country:US
Practice Address - Phone:801-538-2057
Practice Address - Fax:801-596-2515
Is Sole Proprietor?:No
Enumeration Date:2006-01-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT1201233501101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT633733OtherDESERET MUTUAL
UT0942938348SEEOtherEDUCATORS MUTUAL
UT107002692101OtherINTERMOUNTAIN HEALTH CARE