=====================================================
General NPI Number Information
=====================================================
NPI Number | 1922926708
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SELINA SOLVEIG ALEA SCHWERDTFEGER LPA
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/08/2026
-----------------------------------------------------
Last Update Date | 07/08/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8064 N POINT BLVD STE 208
-----------------------------------------------------
City | WINSTON SALEM
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27106-3235
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 336-300-0604
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8064 N POINT BLVD STE 208
-----------------------------------------------------
City | WINSTON SALEM
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27106-3235
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 336-300-0604
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103TC0700X
-----------------------------------------------------
Taxonomy Name | Clinical Psychologist
-----------------------------------------------------
License Number | 7050
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------