Healthcare Provider Details

I. General information

NPI: 1083341663
Provider Name (Legal Business Name): SELENA SENA-HOPKINS MA, LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2022
Last Update Date: 08/04/2022
Certification Date: 08/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1809 SHERIDAN ST
PORT TOWNSEND WA
98368-7610
US

IV. Provider business mailing address

1809 SHERIDAN ST
PORT TOWNSEND WA
98368-7610
US

V. Phone/Fax

Practice location:
  • Phone: 360-379-5109
  • Fax:
Mailing address:
  • Phone: 360-379-5109
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLH61126490
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: