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General NPI Number Information
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NPI Number | 1235068685
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Entity Type | Individual
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Provider Name | LACEY MARIE SELMAN LLMSW
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Gender | Female
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Dates
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Enumeration Date | 05/13/2026
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Last Update Date | 05/13/2026
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Provider Practice Location Address
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Address Line | 3550 E RIVER RD
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City | OSCODA
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State | MI
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Zip | 48750-9025
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Country | US
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Telephone | 989-739-9121
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Fax |
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Provider Business Mailing Address
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Address Line | 520 S LORENZ RD
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City | TAWAS CITY
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State | MI
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Zip | 48763-9801
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Country | US
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Telephone | 989-296-9624
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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 | 1041S0200X
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Taxonomy Name | School Social Worker
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License Number | 6851121875
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6851121875
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License Number State | MI
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