Healthcare Provider Details

I. General information

NPI: 1821900150
Provider Name (Legal Business Name): JESSICA NICOLE SELLERS LMSW, DSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1909 COMMERCE AVE
CULLMAN AL
35055-6151
US

IV. Provider business mailing address

109 MONICA AVE
DECATUR AL
35603-5469
US

V. Phone/Fax

Practice location:
  • Phone: 256-734-4688
  • Fax:
Mailing address:
  • Phone: 256-398-5130
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number6852G
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: