Mary Jo Seidl, CSAC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

11211-132 Issued in WI

Practice address

1701 Dousman St
Green Bay, WI 54303-3211

Phone

(920) 498-8600

NPI assigned

Aug 10, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1281398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281398400000",
    "number": "1750696100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1185 DIVISION ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543033050",
            "telephone_number": "920-255-1387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 DOUSMAN ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543033211",
            "telephone_number": "920-498-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEIDL",
        "first_name": "MARY",
        "middle_name": "JO",
        "credential": "CSAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-10",
        "last_updated": "2010-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "11211-132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patti J Seeman, COTA
• Emily Seewald, APNP
• Nicholas W Seglund, CRNA
• Stephen F Sehring, MD
• Carolyn Susan Seidl, APNP
• Savanha Seidl, RDH
• Sandi L Seiler, DC
• Samantha J Seiltz, NP
• Nathan Seitz, DPT
• Lauren N Seline, M.D.

• Addiction (Substance Use Disorder) Counselor in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Addiction (Substance Use Disorder) Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2010; 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.