Provider Demographics
NPI:1174007926
Name:SELDIN, NANCY J (LICSW)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:J
Last Name:SELDIN
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:
Other - Last Name:SELDIN-VAN DER VOORN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:11 RIVER ST
Mailing Address - Street 2:
Mailing Address - City:WELLESLEY
Mailing Address - State:MA
Mailing Address - Zip Code:02481-2017
Mailing Address - Country:US
Mailing Address - Phone:617-817-6172
Mailing Address - Fax:
Practice Address - Street 1:4838 WOODRIDGE CT
Practice Address - Street 2:
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55345-3935
Practice Address - Country:US
Practice Address - Phone:617-817-6172
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-18
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1032400-SW-LICSW1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical