Individual
CHARLES RICHARD SEABERG JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCDC
Contact information
Practice address
111 NW 24TH ST, FORT WORTH, TX 76164-8544
(817) 626-6401
Mailing address
5704 HAVANA DR, NORTH RICHLAND HILLS, TX 76180-6120
(817) 929-2936
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
3251
TX
Other
Enumeration date
03/01/2013
Last updated
03/01/2013
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