Provider Demographics
NPI:1699552588
Name:SEILER, GWENDOLYN H (LPC)
Entity type:Individual
Prefix:
First Name:GWENDOLYN
Middle Name:H
Last Name:SEILER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:GWEN
Other - Middle Name:
Other - Last Name:SEILER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC
Mailing Address - Street 1:414 MT HAVEN DR
Mailing Address - Street 2:
Mailing Address - City:FOREST
Mailing Address - State:VA
Mailing Address - Zip Code:24551-2108
Mailing Address - Country:US
Mailing Address - Phone:804-399-4634
Mailing Address - Fax:
Practice Address - Street 1:1610A GRAVES MILL RD
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24502-4329
Practice Address - Country:US
Practice Address - Phone:434-219-5621
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-13
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701012856101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional