Provider Demographics
NPI:1407183916
Name:SELZER, ELYSE ALMINA ANN (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:ELYSE
Middle Name:ALMINA ANN
Last Name:SELZER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 E SPRUCE ST
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67846-5958
Mailing Address - Country:US
Mailing Address - Phone:620-276-7689
Mailing Address - Fax:206-276-6117
Practice Address - Street 1:1111 E SPRUCE ST
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:KS
Practice Address - Zip Code:67846-5958
Practice Address - Country:US
Practice Address - Phone:620-276-7689
Practice Address - Fax:620-276-6117
Is Sole Proprietor?:No
Enumeration Date:2009-11-05
Last Update Date:2020-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS621101YA0400X
KS42521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)