Healthcare Provider Details

I. General information

NPI: 1215766209
Provider Name (Legal Business Name): ANGIE M SELLERS MA, LPC, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/29/2024
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 W MAIN ST STE B
ANNVILLE PA
17003-1336
US

IV. Provider business mailing address

350 W MAIN ST STE B
ANNVILLE PA
17003-1336
US

V. Phone/Fax

Practice location:
  • Phone: 717-473-0563
  • Fax: 717-427-7527
Mailing address:
  • Phone: 717-473-0563
  • Fax: 717-427-7527

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberPC020883
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberAPC000256
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: