Healthcare Provider Details

I. General information

NPI: 1861880205
Provider Name (Legal Business Name): AMANDA SELMAN LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/08/2015
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1027 CLIFTWOOD CIR
CLIFTON FORGE VA
24422-1901
US

IV. Provider business mailing address

1027 CLIFTWOOD CIR
CLIFTON FORGE VA
24422-1901
US

V. Phone/Fax

Practice location:
  • Phone: 540-958-0564
  • Fax:
Mailing address:
  • Phone: 540-958-0564
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0701006035
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: