MEDICARE: THE CENTER FOR BODY ORIENTED PSYCHOTHERAPY & WELLNESS

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	103TA0400X	Addiction (Substance Use Disorder) Psychologist
2	103TC1900X	Counseling Psychologist
3	106H00000X	Marriage & Family Therapist
4	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1396134615
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE CENTER FOR BODY ORIENTED PSYCHOTHERAPY & WELLNESS

Provider Business Mailing Address
First Line	:	1626 FOURTH STREET
Second Line	:
City	:	SANTA ROSA
State	:	CA
Zip	:	95404
Country	:	US
Telephone Number	:	707-595-5637
Fax Number	:	707-595-5637

Provider Business Practice Location Address
First Line	:	1626 FOURTH STREET
Second Line	:
City	:	SANTA ROSA
State	:	CA
Zip	:	95404
Country	:	US
Telephone Number	:	707-595-5637
Fax Number	:	707-595-5637

Authorized Official
Title or Position	:	FOUNDER, CLINICAL DIRECTOR
Name	:	MR. RICHARD A. SELCKE
Credential	:	M.F.T.
Telephone Number	:	707-595-5637

Provider Enumeration Date	:	01/12/2015
Last Update Date	:	01/12/2015

Similar Medicare Providers

1407707052 — ESPERANZA ALCARAZ CRUZ FNP
Practice Location Address:

2499 CEDAR CREEK ST
SANTA ROSA, CA
95404-7741

Practice Phone: 707-478-7676
Practice Fax:

1952252405 — ANDREA S MACE MPSS-PTEUSG
Practice Location Address:

98 HENDLEY ST
SANTA ROSA, CA
95404-5025

Practice Phone: 707-527-0412
Practice Fax:

1205295979 — MRS. SANDRA LEE KRIKORIAN LCSW
Practice Location Address:

100 E ST STE 314
SANTA ROSA, CA
95404-4607

Practice Phone: 707-579-0838
Practice Fax: 707-620-0367

1760250708 — EMMA SHAW
Practice Location Address:

3371 PARKER HILL RD
SANTA ROSA, CA
95404-1732

Practice Phone: 707-535-0289
Practice Fax:

1174473714 — ARIEL CODDINGTON
Practice Location Address:

1120 GORDON LN
SANTA ROSA, CA
95404-5636

Practice Phone: 707-527-3249
Practice Fax:

1871443416 — JASMINE TOLLINCHI
Practice Location Address:

1120 GORDON LN
SANTA ROSA, CA
95404-5636

Practice Phone: 707-527-3249
Practice Fax:

1922958578 — AHNAYHA-LEE T-BERHE
Practice Location Address:

1120 GORDON LN
SANTA ROSA, CA
95404-5636

Practice Phone: 707-527-3249
Practice Fax:

Directions to “THE CENTER FOR BODY ORIENTED PSYCHOTHERAPY & WELLNESS ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.