Healthcare Provider Details

I. General information

NPI: 1215411129
Provider Name (Legal Business Name): DONNA MICHELE SELLERS LCSW, LISW LCAS, CCS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/18/2018
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 N TRADE ST STE 1
TRYON NC
28782-3053
US

IV. Provider business mailing address

213 OVERLAKE DR
INMAN SC
29349-6600
US

V. Phone/Fax

Practice location:
  • Phone: 864-610-5593
  • Fax: 833-854-5563
Mailing address:
  • Phone: 844-610-5593
  • Fax: 833-954-5563

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number22557
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC013538
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberLCAS-24881
License Number StateNC
# 4
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number15354
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: