Provider Demographics
NPI:1205009255
Name:GUELSEREN, SIBEL N (MED/EDS)
Entity Type:Individual
Prefix:
First Name:SIBEL
Middle Name:N
Last Name:GUELSEREN
Suffix:
Gender:F
Credentials:MED/EDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 WAYLAND PL
Mailing Address - Street 2:
Mailing Address - City:PALM COAST
Mailing Address - State:FL
Mailing Address - Zip Code:32164-7602
Mailing Address - Country:US
Mailing Address - Phone:386-334-3777
Mailing Address - Fax:386-283-5900
Practice Address - Street 1:50 LEANNI WAY
Practice Address - Street 2:SUITE B-3
Practice Address - City:PALM COAST
Practice Address - State:FL
Practice Address - Zip Code:32137-4751
Practice Address - Country:US
Practice Address - Phone:386-334-3777
Practice Address - Fax:386-238-5900
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-10
Last Update Date:2014-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT2120106H00000X
FLCAP 4384101YA0400X
FL101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101Y00000XBehavioral Health & Social Service ProvidersCounselor