Provider Demographics
NPI:1033239967
Name:SELLMAN, SALLY A (MED, LCPC)
Entity Type:Individual
Prefix:MS
First Name:SALLY
Middle Name:A
Last Name:SELLMAN
Suffix:
Gender:F
Credentials:MED, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3105 EMMORTON RD
Mailing Address - Street 2:
Mailing Address - City:ABINGDON
Mailing Address - State:MD
Mailing Address - Zip Code:21009-2582
Mailing Address - Country:US
Mailing Address - Phone:410-569-5900
Mailing Address - Fax:
Practice Address - Street 1:707 HARDWOOD LN
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-4570
Practice Address - Country:US
Practice Address - Phone:410-280-1803
Practice Address - Fax:410-280-1804
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC 1183101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional