Active NPI
Stacey Seale
- Case Manager/Care Coordinator
- Vidalia, LA
National Provider Identifier
1457721474
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- Practice address
- 1650 Camellia St
Vidalia, LA 71373 - Phone
- (318) 758-0469
- NPI assigned
- Oct 2, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 13182 | LA | |
| Case Manager/Care Coordinator | 171M00000X | Primary |
Addresses
Primary practice location
1650 Camellia St
Vidalia, LA 71373
Mailing address
1218 Palm St
Vidalia, LA 71373-3839
Phone (318) 758-0469
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13182 | LA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1443744000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1526947200000",
"number": "1457721474",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1218 PALM ST",
"city": "VIDALIA",
"state": "LA",
"postal_code": "713733839",
"telephone_number": "318-758-0469"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1650 CAMELLIA ST",
"city": "VIDALIA",
"state": "LA",
"postal_code": "71373",
"telephone_number": "318-758-0469"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SEALE",
"first_name": "STACEY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-10-02",
"last_updated": "2018-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "LA",
"license": "13182",
"primary": false
},
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vidalia, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.