Provider Demographics
NPI:1386167351
Name:GREENBLATT, SETH A (LCSW-C)
Entity type:Individual
Prefix:MR
First Name:SETH
Middle Name:A
Last Name:GREENBLATT
Suffix:
Gender:
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 WISCONSIN CIRCLE, SUITE 700
Mailing Address - Street 2:YOUR HEALTH CONCIERGE, INC
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20815
Mailing Address - Country:US
Mailing Address - Phone:844-942-1789
Mailing Address - Fax:
Practice Address - Street 1:1615 L ST NW STE 340
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-5617
Practice Address - Country:US
Practice Address - Phone:703-963-2019
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-21
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD163691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD984039Medicaid
NONEOtherNONE