Provider Demographics
NPI:1194552125
Name:SEASIDE WELLNESS LLC
Entity type:Organization
Organization Name:SEASIDE WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LEAD COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:SYDNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:ZABEL
Authorized Official - Suffix:
Authorized Official - Credentials:MS, ADC-IP, LPC-A
Authorized Official - Phone:720-499-6101
Mailing Address - Street 1:2011 COLDSPRING DR APT F
Mailing Address - Street 2:
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29406-4995
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2011 COLDSPRING DR
Practice Address - Street 2:
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29406-4995
Practice Address - Country:US
Practice Address - Phone:720-499-6101
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-16
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty