Healthcare Provider Details

I. General information

NPI: 1609620400
Provider Name (Legal Business Name): SELENA RHYAN LINDAMOOD LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/16/2024
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2601 PENNINGTON RD
PENNINGTON NJ
08534-3208
US

IV. Provider business mailing address

2601 PENNINGTON RD
PENNINGTON NJ
08534-3208
US

V. Phone/Fax

Practice location:
  • Phone: 609-916-8630
  • Fax:
Mailing address:
  • Phone: 609-916-8630
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number37PC01278600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: