Healthcare Provider Details

I. General information

NPI: 1083486286
Provider Name (Legal Business Name): SELLERS ELIZABETH TERRELL LPC-MHSP, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/23/2023
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1329 17TH AVE S
BIRMINGHAM AL
35205-6607
US

IV. Provider business mailing address

1329 17TH AVE S
BIRMINGHAM AL
35205-6607
US

V. Phone/Fax

Practice location:
  • Phone: 205-789-6557
  • Fax:
Mailing address:
  • Phone: 205-789-6557
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number6706
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC05153
License Number StateAL
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH28292
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: