Provider Demographics
NPI:1508053356
Name:SELLERS, KATHLEEN FOX (LPC)
Entity Type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:FOX
Last Name:SELLERS
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 1:309 E RIDGELEY ST
Mailing Address - Street 2:
Mailing Address - City:ATMORE
Mailing Address - State:AL
Mailing Address - Zip Code:36502-2017
Mailing Address - Country:US
Mailing Address - Phone:251-368-1675
Mailing Address - Fax:251-446-1994
Practice Address - Street 1:309 E RIDGELEY ST
Practice Address - Street 2:
Practice Address - City:ATMORE
Practice Address - State:AL
Practice Address - Zip Code:36502-2017
Practice Address - Country:US
Practice Address - Phone:252-368-1675
Practice Address - Fax:251-446-1994
Is Sole Proprietor?:No
Enumeration Date:2007-09-25
Last Update Date:2007-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1122101YA0400X
ALLPC2523101YM0800X
GALPC002948101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)