MEDICARE: MR. ROBERT F SELBY JR. LMFT,LPC,NCC,CT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	38	LA
2	101YM0800X	Mental Health Counselor	2359	LA

General Provider Information

NPI Number	:	1255511523
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ROBERT F SELBY JR. LMFT,LPC,NCC,CT

Provider Business Mailing Address
First Line	:	10560 AIRLINE HWY
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70816-4109
Country	:	US
Telephone Number	:	225-223-1497
Fax Number	:	225-293-4322

Provider Business Practice Location Address
First Line	:	10560 AIRLINE HWY
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70816-4109
Country	:	US
Telephone Number	:	225-223-1497
Fax Number	:	225-293-4322

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/05/2007
Last Update Date	:	11/05/2007

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