Provider Demographics
NPI:1457915282
Name:SEASONS THERAPY SERVICES, LLC
Entity Type:Organization
Organization Name:SEASONS THERAPY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:WINTER
Authorized Official - Middle Name:C
Authorized Official - Last Name:WESLEY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-C
Authorized Official - Phone:757-581-1090
Mailing Address - Street 1:5 BESAN CT
Mailing Address - Street 2:
Mailing Address - City:WINDSOR MILL
Mailing Address - State:MD
Mailing Address - Zip Code:21244-1401
Mailing Address - Country:US
Mailing Address - Phone:757-581-1090
Mailing Address - Fax:
Practice Address - Street 1:9026 ALLENSWOOD RD
Practice Address - Street 2:
Practice Address - City:RANDALLSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21133-3731
Practice Address - Country:US
Practice Address - Phone:757-581-1090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-26
Last Update Date:2019-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty