=====================================================
General NPI Number Information
=====================================================
NPI Number | 1205495017
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SELDA CELEN-DEMIRTAS, PH.D., PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/06/2019
-----------------------------------------------------
Last Update Date | 10/28/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 48 WATERFIELD RD UNIT 884
-----------------------------------------------------
City | WINCHESTER
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01890-7041
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 781-218-9957
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 48 WATERFIELD RD UNIT 884
-----------------------------------------------------
City | WINCHESTER
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01890-7041
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 781-218-9957
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | SELDA CELEN-DEMIRTAS
-----------------------------------------------------
Credential | PH.D.
-----------------------------------------------------
Telephone | 781-218-9957
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103TC1900X
-----------------------------------------------------
Taxonomy Name | Counseling Psychologist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------