Healthcare Provider Details

I. General information

NPI: 1891834479
Provider Name (Legal Business Name): DEBORAH LYNN SELLERS B.S.W., LCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/06/2007
Last Update Date: 07/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

249 FRIENDLY ST
ANCHORAGE AK
99504-1551
US

IV. Provider business mailing address

249 FRIENDLY ST
ANCHORAGE AK
99504-1551
US

V. Phone/Fax

Practice location:
  • Phone: 907-929-3548
  • Fax: 907-929-3548
Mailing address:
  • Phone: 907-929-3548
  • Fax: 907-929-3548

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number416436
License Number StateAK
# 2
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number416436
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: