Provider Demographics
NPI:1477835718
Name:SELENSKY, KRISTI LYNN (LPC)
Entity Type:Individual
Prefix:
First Name:KRISTI
Middle Name:LYNN
Last Name:SELENSKY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4101 PERIMETER CENTER DR
Mailing Address - Street 2:STE. 250
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-2302
Mailing Address - Country:US
Mailing Address - Phone:405-751-0800
Mailing Address - Fax:405-751-6488
Practice Address - Street 1:4101 PERIMETER CENTER DR
Practice Address - Street 2:STE. 250
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-2302
Practice Address - Country:US
Practice Address - Phone:405-751-0800
Practice Address - Fax:405-751-6488
Is Sole Proprietor?:No
Enumeration Date:2011-09-13
Last Update Date:2011-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3937101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100745880Medicaid