Provider Demographics
NPI:1255067625
Name:SEIFFERT, TYLER JUSTIN (LSW)
Entity type:Individual
Prefix:
First Name:TYLER
Middle Name:JUSTIN
Last Name:SEIFFERT
Suffix:
Gender:M
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 N PRINCE ST
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17603-3010
Mailing Address - Country:US
Mailing Address - Phone:717-560-7917
Mailing Address - Fax:717-560-6452
Practice Address - Street 1:354 N PRINCE ST STE 120
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17603-3085
Practice Address - Country:US
Practice Address - Phone:717-553-5341
Practice Address - Fax:717-869-6411
Is Sole Proprietor?:No
Enumeration Date:2022-07-28
Last Update Date:2022-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW139094104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker