Provider Demographics
NPI:1366266009
Name:SEABROOK, JAMES MCELDOWNEY III
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:MCELDOWNEY
Last Name:SEABROOK
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3864
Mailing Address - Street 2:
Mailing Address - City:PARK CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84060-3864
Mailing Address - Country:US
Mailing Address - Phone:856-371-6834
Mailing Address - Fax:
Practice Address - Street 1:1887 GOLD DUST LN
Practice Address - Street 2:
Practice Address - City:PARK CITY
Practice Address - State:UT
Practice Address - Zip Code:84060-7288
Practice Address - Country:US
Practice Address - Phone:856-371-6834
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-11
Last Update Date:2024-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT10793679-6004101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health