Provider Demographics
NPI:1467821124
Name:SELLERS, MELISSA RACHEL (LMHC)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:RACHEL
Last Name:SELLERS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4548 SANDY COVE TER
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33467-1112
Mailing Address - Country:US
Mailing Address - Phone:631-258-6209
Mailing Address - Fax:
Practice Address - Street 1:1230 S FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33435-6000
Practice Address - Country:US
Practice Address - Phone:631-258-6209
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-23
Last Update Date:2018-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006817101YM0800X
FLMH13980101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health