Provider Demographics
NPI:1689693400
Name:SELLERS, MARIA ANN (LPC)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:ANN
Last Name:SELLERS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:ANN
Other - Last Name:CAROCCI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MARIA SELLERS DPM
Mailing Address - Street 1:441 SNOW TRAIL DR
Mailing Address - Street 2:
Mailing Address - City:FINDLAY
Mailing Address - State:OH
Mailing Address - Zip Code:45840-8603
Mailing Address - Country:US
Mailing Address - Phone:419-348-9829
Mailing Address - Fax:
Practice Address - Street 1:441 SNOW TRAIL DR
Practice Address - Street 2:
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840-8603
Practice Address - Country:US
Practice Address - Phone:419-348-9829
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36043587213E00000X
OHC.2305406101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0147924Medicaid
OH000000139907OtherANTHEMBCBS
OH000000139907OtherANTHEMBCBS
OH0788716Medicare PIN
OH480020911Medicare PIN