Organization Active NPI

Sea Therapy LLC

  • Community/Behavioral Health Agency
  • Elkhart, IN
National Provider Identifier
1215467659
Registry record updated Jul 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
309003032A Issued in IN
Legal business name
SEA THERAPY LLC
Practice address
1004 Parkway Ave Ste D
Elkhart, IN 46516-9349
Phone
(574) 293-0005
NPI assigned
Jun 18, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Stephanie K McIntosh Szabo, LMHC, LCAC
Title
Owner
Phone
(574) 612-4556

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 309003032A IN Primary
Community/Behavioral Health Agency 251S00000X 87000369A IN

Addresses

Primary practice location

1004 Parkway Ave Ste D
Elkhart, IN 46516-9349

Mailing address

29765 County Road 118
Elkhart, IN 46517-9392
Phone (574) 612-4556

Other identifiers 1

IdentifierTypeStateIssuer
11844637OtherINCAQH

National Provider Directory

National Provider Directory

Locations

1004 Parkway Ave
Ste D
Elkhart, IN 46516
Phone (574) 293-0005

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1497744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1499558400000",
    "number": "1215467659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29765 COUNTY ROAD 118",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465179392",
            "telephone_number": "574-612-4556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1004 PARKWAY AVE STE D",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465169349",
            "telephone_number": "574-293-0005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEA THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-18",
        "last_updated": "2017-07-09",
        "status": "A",
        "authorized_official_last_name": "MCINTOSH SZABO",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "574-612-4556",
        "authorized_official_credential": "LMHC, LCAC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "IN",
            "license": "309003032A",
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "IN",
            "license": "87000369A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11844637",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkhart, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.