Provider Demographics
NPI:1477128643
Name:SELAH COUNSELING INC.
Entity Type:Organization
Organization Name:SELAH COUNSELING INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LMFT
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:ALICE
Authorized Official - Last Name:YBARRA
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:559-316-1097
Mailing Address - Street 1:1631 NE BROADWAY ST
Mailing Address - Street 2:PMB 750
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97232
Mailing Address - Country:US
Mailing Address - Phone:559-316-1097
Mailing Address - Fax:
Practice Address - Street 1:1295 N WISHON AVE STE 211
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93728-2350
Practice Address - Country:US
Practice Address - Phone:559-316-1097
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-20
Last Update Date:2023-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA53050OtherCALIFORNIA BOARD OF BEHAVIORAL SCIENCES