Provider Demographics
NPI:1295744464
Name:SEAMON, REBECCA ELIZABETH (LPC)
Entity type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:ELIZABETH
Last Name:SEAMON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 OAK HOLLOW CT
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30004-0820
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:415 OAK HOLLOW CT
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30004-0820
Practice Address - Country:US
Practice Address - Phone:925-451-7520
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2016-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17882101YP2500X
GALPC009321101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX83520LOtherBCBS PROVIDER NUMBER
TX1538761-01Medicaid
TX83520LOtherBCBS PROVIDER NUMBER