Provider Demographics
NPI:1154868214
Name:SELK, LINDSAY (LCSW)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:
Last Name:SELK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:181 S 600 W
Mailing Address - Street 2:BLD 3A BAY 1
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84404-1331
Mailing Address - Country:US
Mailing Address - Phone:385-220-9498
Mailing Address - Fax:
Practice Address - Street 1:181 S 600 W
Practice Address - Street 2:BLD 3A BAY 1
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84404-1331
Practice Address - Country:US
Practice Address - Phone:385-220-9498
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-27
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
UT1041992135011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical