Provider Demographics
NPI:1568874162
Name:REBECCA SELOVER, NCC, LMHC, L.L.C.
Entity Type:Organization
Organization Name:REBECCA SELOVER, NCC, LMHC, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:MS
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:SELOVER
Authorized Official - Suffix:
Authorized Official - Credentials:NCC,LMHC
Authorized Official - Phone:407-617-2843
Mailing Address - Street 1:312 W 1ST ST STE 107
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32771-1270
Mailing Address - Country:US
Mailing Address - Phone:407-617-2843
Mailing Address - Fax:407-324-1631
Practice Address - Street 1:312 W 1ST ST STE 107
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:FL
Practice Address - Zip Code:32771-1270
Practice Address - Country:US
Practice Address - Phone:407-617-2843
Practice Address - Fax:407-324-1631
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-30
Last Update Date:2014-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH8871251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health