Organization
SEA THERAPY LLC
Active
Organization
SEA THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE K MCINTOSH SZABO LMHC, LCAC (OWNER)
(574) 612-4556
Entity
Organization
Contact information
Practice address
1004 PARKWAY AVE STE D, ELKHART, IN 46516-9349
(574) 293-0005
Mailing address
29765 COUNTY ROAD 118, ELKHART, IN 46517-9392
(574) 612-4556
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
309003032A
IN
251S00000X
Community/Behavioral Health Agency
87000369A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11844637
CAQH
IN
Enumeration date
06/18/2017
Last updated
07/09/2017
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