Individual provider Active NPI

David Allen Sedlacek, PH.D.

  • Clinical Social Worker
  • Huntsville, AL
National Provider Identifier
1477641355
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1870C Issued in AL
Practice address
7000 Adventist Blvd NW
Green Hall Room 205
Huntsville, AL 35896-0001
Phone
(256) 726-7607
Fax
(256) 726-7527
NPI assigned
Oct 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 1870C AL Primary

Addresses

Primary practice location

7000 Adventist Blvd NW
Green Hall Room 205
Huntsville, AL 35896-0001

Mailing address

302 Bob G Hughes Blvd
Harvest, AL 35749-4861
Phone (256) 830-5448

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)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
1870CALMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1477641355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 BOB G HUGHES BLVD",
            "city": "HARVEST",
            "state": "AL",
            "postal_code": "357494861",
            "telephone_number": "256-830-5448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7000 ADVENTIST BLVD NW",
            "address_2": "GREEN HALL ROOM 205",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358960001",
            "telephone_number": "256-726-7607",
            "fax_number": "256-726-7527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEDLACEK",
        "first_name": "DAVID",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AL",
            "license": "1870C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.