Provider Demographics
NPI:1831771534
Name:SEIDMAN, MEGAN ANNE (LMHC)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:ANNE
Last Name:SEIDMAN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16181 MERIDA LN
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33484-6448
Mailing Address - Country:US
Mailing Address - Phone:786-495-2627
Mailing Address - Fax:
Practice Address - Street 1:4600 LINTON BLVD STE 250
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33445-6600
Practice Address - Country:US
Practice Address - Phone:561-496-1094
Practice Address - Fax:561-496-1069
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-22
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL17869101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health