Provider Demographics
NPI:1316070600
Name:GARRED, SEAN PATRICK (MED LPC CRC)
Entity type:Individual
Prefix:MR
First Name:SEAN
Middle Name:PATRICK
Last Name:GARRED
Suffix:
Gender:M
Credentials:MED LPC CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:150 W DUBOIS AVENUE
Mailing Address - Street 2:JUNIATA PLACE SUITE B
Mailing Address - City:DU BOIS
Mailing Address - State:PA
Mailing Address - Zip Code:15801-1967
Mailing Address - Country:US
Mailing Address - Phone:814-375-7090
Mailing Address - Fax:814-375-7940
Practice Address - Street 1:150 W DUBOIS AVENUE
Practice Address - Street 2:JUNIATA PLACE
Practice Address - City:DU BOIS
Practice Address - State:PA
Practice Address - Zip Code:15801-1967
Practice Address - Country:US
Practice Address - Phone:814-375-7090
Practice Address - Fax:814-375-7940
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS007054L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0017312240003Medicaid
489548OtherHIGHMARK
GA1341410OtherPREMIER BLUE