Provider Demographics
NPI:1669491346
Name:MICHELE SELOVER
Entity Type:Organization
Organization Name:MICHELE SELOVER
Other - Org Name:ADVANCED COUNSELING SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:SELOVER
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LLP
Authorized Official - Phone:734-737-1200
Mailing Address - Street 1:5958 N CANTON CENTER RD
Mailing Address - Street 2:SUITE 900
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48187-2765
Mailing Address - Country:US
Mailing Address - Phone:734-737-1200
Mailing Address - Fax:734-737-1205
Practice Address - Street 1:5958 N CANTON CENTER RD
Practice Address - Street 2:SUITE 900
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48187-2765
Practice Address - Country:US
Practice Address - Phone:734-737-1200
Practice Address - Fax:734-737-1205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-19
Last Update Date:2009-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301011912103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty