Provider Demographics
NPI:1457516627
Name:SEABERG, JENNIFER MARIE (MFT)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:MARIE
Last Name:SEABERG
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:MISS
Other - First Name:JENNIFER
Other - Middle Name:MARIE
Other - Last Name:VAN HOUTEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MFT
Mailing Address - Street 1:15 ELIAB LATHAM WAY
Mailing Address - Street 2:
Mailing Address - City:EAST BRIDGEWATER
Mailing Address - State:MA
Mailing Address - Zip Code:02333-2400
Mailing Address - Country:US
Mailing Address - Phone:781-351-1634
Mailing Address - Fax:
Practice Address - Street 1:15 ELIAB LATHAM WAY
Practice Address - Street 2:
Practice Address - City:EAST BRIDGEWATER
Practice Address - State:MA
Practice Address - Zip Code:02333-2400
Practice Address - Country:US
Practice Address - Phone:781-351-1634
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-27
Last Update Date:2013-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist