Provider Demographics
NPI:1730621673
Name:SEITZ-MC GUIRE, JANE (CASAC)
Entity type:Individual
Prefix:
First Name:JANE
Middle Name:
Last Name:SEITZ-MC GUIRE
Suffix:
Gender:F
Credentials:CASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 BRIGHTWOOD ST
Mailing Address - Street 2:
Mailing Address - City:PATCHOGUE
Mailing Address - State:NY
Mailing Address - Zip Code:11772-3634
Mailing Address - Country:US
Mailing Address - Phone:631-494-8058
Mailing Address - Fax:631-647-3130
Practice Address - Street 1:43 BRIGHTWOOD ST
Practice Address - Street 2:
Practice Address - City:PATCHOGUE
Practice Address - State:NY
Practice Address - Zip Code:11772-3634
Practice Address - Country:US
Practice Address - Phone:631-494-8058
Practice Address - Fax:631-647-3130
Is Sole Proprietor?:No
Enumeration Date:2016-11-09
Last Update Date:2016-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY9945101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)