Provider Demographics
NPI:1215156583
Name:SEYMOUR, CHRISTINE KAY (LPC)
Entity type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:KAY
Last Name:SEYMOUR
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:559 N STONE ST
Mailing Address - Street 2:
Mailing Address - City:WEST SUFFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06093-3214
Mailing Address - Country:US
Mailing Address - Phone:860-254-5055
Mailing Address - Fax:860-254-5055
Practice Address - Street 1:559 N STONE ST
Practice Address - Street 2:
Practice Address - City:WEST SUFFIELD
Practice Address - State:CT
Practice Address - Zip Code:06093-3214
Practice Address - Country:US
Practice Address - Phone:860-254-5055
Practice Address - Fax:860-254-5055
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0011211101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional