Provider Demographics
NPI:1194116657
Name:SEELOW, ELIZABETH CATHERINE I (LPCIT)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:CATHERINE
Last Name:SEELOW
Suffix:I
Gender:F
Credentials:LPCIT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:W175N11120 STONEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:WI
Mailing Address - Zip Code:53022-6511
Mailing Address - Country:US
Mailing Address - Phone:262-345-5533
Mailing Address - Fax:262-293-9737
Practice Address - Street 1:1049 N LYNNDALE DR
Practice Address - Street 2:SUITE 1B
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54914-3050
Practice Address - Country:US
Practice Address - Phone:800-282-0561
Practice Address - Fax:262-345-5608
Is Sole Proprietor?:No
Enumeration Date:2015-02-05
Last Update Date:2015-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2424-226101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional