Provider Demographics
NPI:1689740904
Name:SELLERS, AMY FELICE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:AMY
Middle Name:FELICE
Last Name:SELLERS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7584 OLD MADISON PIKE NW
Mailing Address - Street 2:#214
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35806-4505
Mailing Address - Country:US
Mailing Address - Phone:706-575-1690
Mailing Address - Fax:
Practice Address - Street 1:USA MEDDAC
Practice Address - Street 2:ATTN MCXW QM
Practice Address - City:REDSTONE ARSENAL
Practice Address - State:AL
Practice Address - Zip Code:35809
Practice Address - Country:US
Practice Address - Phone:703-365-0788
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL76571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical