Provider Demographics
NPI:1366717159
Name:HORSLEY, SEAN C (LCSW)
Entity type:Individual
Prefix:MR
First Name:SEAN
Middle Name:C
Last Name:HORSLEY
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:905 N 1000 E
Mailing Address - Street 2:
Mailing Address - City:TREMONTON
Mailing Address - State:UT
Mailing Address - Zip Code:84337
Mailing Address - Country:US
Mailing Address - Phone:435-207-4741
Mailing Address - Fax:435-207-4685
Practice Address - Street 1:905 N 1000 E
Practice Address - Street 2:
Practice Address - City:TREMONTON
Practice Address - State:UT
Practice Address - Zip Code:84337
Practice Address - Country:US
Practice Address - Phone:435-207-4741
Practice Address - Fax:435-207-4685
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-13
Last Update Date:2021-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT128372-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT12221973Medicare PIN