Provider Demographics
NPI:1992251235
Name:SEEDORF, ASHLEY ANN (LPCC)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:ANN
Last Name:SEEDORF
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:313 MAIN AVENUE
Mailing Address - Street 2:
Mailing Address - City:DEER RIVER
Mailing Address - State:MN
Mailing Address - Zip Code:56636
Mailing Address - Country:US
Mailing Address - Phone:218-289-2590
Mailing Address - Fax:218-246-9849
Practice Address - Street 1:313 MAIN AVENUE
Practice Address - Street 2:
Practice Address - City:DEER RIVER
Practice Address - State:MN
Practice Address - Zip Code:56636
Practice Address - Country:US
Practice Address - Phone:218-289-2590
Practice Address - Fax:218-246-9849
Is Sole Proprietor?:No
Enumeration Date:2016-08-28
Last Update Date:2016-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCC01250101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health