Provider Demographics
NPI:1699720342
Name:SEITZ, DANIEL D (MA, LCSW, LMFT, LCAC)
Entity type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:D
Last Name:SEITZ
Suffix:
Gender:M
Credentials:MA, LCSW, LMFT, LCAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5230 S WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:IN
Mailing Address - Zip Code:46953-5778
Mailing Address - Country:US
Mailing Address - Phone:765-674-2208
Mailing Address - Fax:765-674-3273
Practice Address - Street 1:5230 S WESTERN AVE
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:IN
Practice Address - Zip Code:46953-5778
Practice Address - Country:US
Practice Address - Phone:765-674-2208
Practice Address - Fax:765-674-3273
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2015-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34002818A1041C0700X
IN35001201A106H00000X
IN87001509A101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN064616000OtherMAGELLAN
IN5884529OtherAETNA
IN000000175677OtherBCBS
IN2036860OtherCIGNA HEALTHCARE
IN000095608OtherOPTRUM HEALTH AKA UNITED BEHAVIORAL HEALTH
IN000095608OtherOPTRUM HEALTH AKA UNITED BEHAVIORAL HEALTH