Provider Demographics
NPI:1780883603
Name:SEABROOK, SHENLEY M (LMHC, BCBA)
Entity type:Individual
Prefix:MRS
First Name:SHENLEY
Middle Name:M
Last Name:SEABROOK
Suffix:
Gender:F
Credentials:LMHC, BCBA
Other - Prefix:MS
Other - First Name:SHENLEY
Other - Middle Name:M
Other - Last Name:ROBERTS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8200 GEORGIA ST
Mailing Address - Street 2:
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410-6227
Mailing Address - Country:US
Mailing Address - Phone:219-791-1400
Mailing Address - Fax:219-791-1422
Practice Address - Street 1:8200 GEORGIA ST
Practice Address - Street 2:
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-6227
Practice Address - Country:US
Practice Address - Phone:219-791-1400
Practice Address - Fax:219-791-1422
Is Sole Proprietor?:No
Enumeration Date:2007-07-11
Last Update Date:2013-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39002461A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health