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General NPI Number Information
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NPI Number | 1083486286
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Entity Type | Individual
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Provider Name | SELLERS ELIZABETH TERRELL MS, LPC-MHSP, LPC
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Gender | Female
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Dates
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Enumeration Date | 10/23/2023
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Last Update Date | 09/09/2024
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Provider Practice Location Address
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Address Line | 1329 17TH AVE S
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City | BIRMINGHAM
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State | AL
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Zip | 35205-6607
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Country | US
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Telephone | 205-789-6557
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Fax |
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Provider Business Mailing Address
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Address Line | 1329 17TH AVE S
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City | BIRMINGHAM
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State | AL
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Zip | 35205-6607
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Country | US
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Telephone | 205-789-6557
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC05153
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 6706
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License Number State | TN
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