Provider Demographics
NPI:1215320544
Name:SEIDL, KATHERINE ELFRIDA (LMSW)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:ELFRIDA
Last Name:SEIDL
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:
Other - Last Name:DAVES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1011 WHISPERING PINE RD
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72210-5422
Mailing Address - Country:US
Mailing Address - Phone:501-231-0353
Mailing Address - Fax:
Practice Address - Street 1:1011 WHISPERING PINE RD
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72210-5422
Practice Address - Country:US
Practice Address - Phone:501-231-0353
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-11
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1597101YA0400X
AR1032-M1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)