Provider Demographics
NPI:1578169041
Name:SELLS, JANET ELISE (LMFT)
Entity Type:Individual
Prefix:MS
First Name:JANET
Middle Name:ELISE
Last Name:SELLS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:MS
Other - First Name:JAN
Other - Middle Name:ELISE
Other - Last Name:SELLS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMFT
Mailing Address - Street 1:2723 STUART ST APT A
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94705-1348
Mailing Address - Country:US
Mailing Address - Phone:510-220-1061
Mailing Address - Fax:
Practice Address - Street 1:2723 STUART ST APT A
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94705-1348
Practice Address - Country:US
Practice Address - Phone:510-220-1061
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-09
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA27505106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist