Provider Demographics
NPI:1902057391
Name:SEERY, WILLIAM LEWIS
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:LEWIS
Last Name:SEERY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:933 W LIND ST
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85705-3421
Mailing Address - Country:US
Mailing Address - Phone:520-461-0028
Mailing Address - Fax:
Practice Address - Street 1:220 E WETMORE RD STE 215
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85705-1748
Practice Address - Country:US
Practice Address - Phone:520-461-0028
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-03
Last Update Date:2009-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLMFT10276106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist