Active NPI
Ryan B Seedall, LMFT
- Marriage & Family Therapist
- Logan, UT
National Provider Identifier
1114136637
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 4101006374
- Practice address
- 6405 Old Main Hill
Logan, UT 84322-6405 - Phone
- (435) 797-7430
- Fax
- (844) 308-5865
- NPI assigned
- May 21, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 4101006374 | MI | Primary |
Addresses
Primary practice location
6405 Old Main Hill
Logan, UT 84322-6405
Mailing address
6405 Old Main Hill
Logan, UT 84322-6435
Phone (435) 797-7430
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Nov 14, 2024 through Nov 14, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4101006374 | MI | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179705600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1562284800000",
"number": "1114136637",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6405 OLD MAIN HILL",
"city": "LOGAN",
"state": "UT",
"postal_code": "843226435",
"telephone_number": "435-797-7430",
"fax_number": "844-308-5865"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6405 OLD MAIN HILL",
"city": "LOGAN",
"state": "UT",
"postal_code": "843226405",
"telephone_number": "435-797-7430",
"fax_number": "844-308-5865"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SEEDALL",
"first_name": "RYAN",
"middle_name": "B",
"credential": "LMFT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-21",
"last_updated": "2019-07-05",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "MI",
"license": "4101006374",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Logan, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.