Provider Demographics
NPI:1598509747
Name:SEAVEY, JAMES REUBEN JR (MA LCPC)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:REUBEN
Last Name:SEAVEY
Suffix:JR
Gender:M
Credentials:MA LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7607 W ASTLE LN
Mailing Address - Street 2:
Mailing Address - City:MAPLETON
Mailing Address - State:IL
Mailing Address - Zip Code:61547-9619
Mailing Address - Country:US
Mailing Address - Phone:309-540-9321
Mailing Address - Fax:
Practice Address - Street 1:7607 W ASTLE LN
Practice Address - Street 2:
Practice Address - City:MAPLETON
Practice Address - State:IL
Practice Address - Zip Code:61547-9619
Practice Address - Country:US
Practice Address - Phone:309-540-9321
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-22
Last Update Date:2024-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180001434101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty