Provider Demographics
NPI:1316993504
Name:SEAY, ELICIA M (PHD)
Entity type:Individual
Prefix:MS
First Name:ELICIA
Middle Name:M
Last Name:SEAY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7019 BACKLICK CT
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22151-3903
Mailing Address - Country:US
Mailing Address - Phone:703-354-1144
Mailing Address - Fax:703-831-8752
Practice Address - Street 1:7019 BACKLICK CT
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22151-3903
Practice Address - Country:US
Practice Address - Phone:703-354-1144
Practice Address - Fax:703-831-8752
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-26
Last Update Date:2008-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810003504103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q48340Medicare UPIN