Healthcare Provider Details
I. General information
NPI: 1588815260
Provider Name (Legal Business Name): DENISE ANNETTE SELLERS LMHC, LCAC, MS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 10/01/2008
Last Update Date: 01/31/2024
Certification Date: 01/31/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8310 ALLISON POINTE BLVD STE 203B
INDIANAPOLIS IN
46250-1998
US
IV. Provider business mailing address
13712 ASHWOOD LN
FISHERS IN
46038-8516
US
V. Phone/Fax
- Phone: 574-360-4175
- Fax:
- Phone: 574-360-4175
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | 39002198A |
| License Number State | IN |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: