Provider Demographics
NPI:1306911524
Name:SEAL, LUNA MAY (LPC)
Entity type:Individual
Prefix:
First Name:LUNA MAY
Middle Name:
Last Name:SEAL
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 1:49 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:WEAVERVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28787-9420
Mailing Address - Country:US
Mailing Address - Phone:828-713-2864
Mailing Address - Fax:
Practice Address - Street 1:49 CHURCH ST
Practice Address - Street 2:
Practice Address - City:WEAVERVILLE
Practice Address - State:NC
Practice Address - Zip Code:28787-9420
Practice Address - Country:US
Practice Address - Phone:828-713-2864
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-22
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5259101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5259OtherNCBLPC
NC6103257Medicaid