Provider Demographics
NPI:1205959186
Name:SEATON, DAVID CHARLES (PHD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:CHARLES
Last Name:SEATON
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4545 N 36TH ST STE 115
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018-3473
Mailing Address - Country:US
Mailing Address - Phone:602-956-2936
Mailing Address - Fax:
Practice Address - Street 1:4545 N 36TH ST STE 115
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85018-3473
Practice Address - Country:US
Practice Address - Phone:602-956-2936
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-07
Last Update Date:2019-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3014103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZPSY-003014OtherAZ STATE BOARD OF PSYCHOLOGIST EXAMINERS