Provider Demographics
NPI:1255984902
Name:SEAHORSE BEHAVIORAL, INC.
Entity type:Organization
Organization Name:SEAHORSE BEHAVIORAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER, PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRIANNE
Authorized Official - Middle Name:P
Authorized Official - Last Name:LIENKAMP
Authorized Official - Suffix:
Authorized Official - Credentials:NP, ANP-BC, PMHNP-BC
Authorized Official - Phone:404-798-0670
Mailing Address - Street 1:PO BOX 975
Mailing Address - Street 2:156 FRONT STREET UNIT 2
Mailing Address - City:MARION
Mailing Address - State:MA
Mailing Address - Zip Code:02738-1538
Mailing Address - Country:US
Mailing Address - Phone:404-798-0670
Mailing Address - Fax:
Practice Address - Street 1:156 FRONT ST UNIT 2
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:MA
Practice Address - Zip Code:02738-1501
Practice Address - Country:US
Practice Address - Phone:404-798-0670
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-22
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty