MEDICARE: KRISTI LYNN SELENSKY LPC

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	101YM0800X	Mental Health Counselor	3937	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1477835718
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTI LYNN SELENSKY LPC

Provider Business Mailing Address
First Line	:	4101 PERIMETER CENTER DR
Second Line	:	STE. 250
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-2302
Country	:	US
Telephone Number	:	405-751-0800
Fax Number	:	405-751-6488

Provider Business Practice Location Address
First Line	:	4101 PERIMETER CENTER DR
Second Line	:	STE. 250
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-2302
Country	:	US
Telephone Number	:	405-751-0800
Fax Number	:	405-751-6488

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

Provider Enumeration Date	:	09/13/2011
Last Update Date	:	09/13/2011

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