Provider Demographics
NPI:1477941763
Name:SELL, MARLO (MS,NCC, LPCA)
Entity Type:Individual
Prefix:
First Name:MARLO
Middle Name:
Last Name:SELL
Suffix:
Gender:F
Credentials:MS,NCC, LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1013 LIGHTFOOT CT
Mailing Address - Street 2:NONE
Mailing Address - City:WAKE FOREST
Mailing Address - State:NC
Mailing Address - Zip Code:27587-9342
Mailing Address - Country:US
Mailing Address - Phone:919-701-9075
Mailing Address - Fax:
Practice Address - Street 1:1013 LIGHTFOOT CT
Practice Address - Street 2:NONE
Practice Address - City:WAKE FOREST
Practice Address - State:NC
Practice Address - Zip Code:27587-9342
Practice Address - Country:US
Practice Address - Phone:919-701-9075
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-08
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA11359101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health