MEDICARE: SELDEN HOLT LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	C004679	NC

General Provider Information

NPI Number	:	1174600647
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SELDEN HOLT LCSW

Provider Business Mailing Address
First Line	:	200 N GREENSBORO ST
Second Line	:	SUITE C6
City	:	CARRBORO
State	:	NC
Zip	:	27510-1833
Country	:	US
Telephone Number	:	919-942-7363
Fax Number	:	919-942-7379

Provider Business Practice Location Address
First Line	:	200 N GREENSBORO ST
Second Line	:	SUITE C6
City	:	CARRBORO
State	:	NC
Zip	:	27510-1833
Country	:	US
Telephone Number	:	919-942-7363
Fax Number	:	919-942-7379

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	03/17/2009

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