Organization
MAVERICK MENTAL HEALTH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AMANDA SEABOLT PH.D. (OWNER)
(419) 266-5251
Entity
Organization
Contact information
Practice address
7110 W CENTRAL AVE STE E, TOLEDO, OH 43617-3115
(419) 266-0072
(419) 754-2306
Mailing address
7110 W CENTRAL AVE STE E, TOLEDO, OH 43617-3115
(419) 266-0072
(419) 754-2306
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0122140
—
OH
Enumeration date
03/12/2025
Last updated
03/11/2026
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