Provider Demographics
NPI:1306614714
Name:THERESA SEWARD, PLLC
Entity type:Organization
Organization Name:THERESA SEWARD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:SEWARD
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:623-330-1099
Mailing Address - Street 1:PO BOX 2078
Mailing Address - Street 2:
Mailing Address - City:SUN CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:85372-2078
Mailing Address - Country:US
Mailing Address - Phone:623-330-1099
Mailing Address - Fax:623-583-3888
Practice Address - Street 1:12301 W BELL RD STE A102
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85378-9707
Practice Address - Country:US
Practice Address - Phone:623-330-1099
Practice Address - Fax:623-583-3888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-14
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health