Provider Demographics
NPI:1699508028
Name:SETH SHOWALTER LCSW LLC
Entity type:Organization
Organization Name:SETH SHOWALTER LCSW LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:SETH
Authorized Official - Middle Name:B
Authorized Official - Last Name:SHOWALTER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:573-303-4632
Mailing Address - Street 1:210 NIKKI WAY
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65203-7000
Mailing Address - Country:US
Mailing Address - Phone:573-416-0801
Mailing Address - Fax:
Practice Address - Street 1:210 NIKKI WAY
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65203-7000
Practice Address - Country:US
Practice Address - Phone:573-416-0801
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-21
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty