Provider Demographics
NPI:1992155733
Name:SEALEY, LINDA (LPC)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:SEALEY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1937 WARD STORE RD
Mailing Address - Street 2:
Mailing Address - City:FAIRMONT
Mailing Address - State:NC
Mailing Address - Zip Code:28340-6451
Mailing Address - Country:US
Mailing Address - Phone:910-674-1009
Mailing Address - Fax:
Practice Address - Street 1:1937 WARD STORE RD
Practice Address - Street 2:
Practice Address - City:FAIRMONT
Practice Address - State:NC
Practice Address - Zip Code:28340-6451
Practice Address - Country:US
Practice Address - Phone:910-674-1009
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-13
Last Update Date:2018-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12736101Y00000X, 101YM0800X, 101YP2500X
SC6881101Y00000X, 101YM0800X, 101YP2500X
SC249101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health