Provider Demographics
NPI:1689750721
Name:SELLERS, TARAH LEIGH (LPC, NCC)
Entity Type:Individual
Prefix:MS
First Name:TARAH
Middle Name:LEIGH
Last Name:SELLERS
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:TARAH
Other - Middle Name:LEIGH
Other - Last Name:GOODWIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1041 W BRIDGE ST
Mailing Address - Street 2:STE 1
Mailing Address - City:PHOENIXVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19460-4342
Mailing Address - Country:US
Mailing Address - Phone:610-933-8110
Mailing Address - Fax:610-933-7451
Practice Address - Street 1:1041 W BRIDGE ST
Practice Address - Street 2:SUITE 1
Practice Address - City:PHOENIXVILLE
Practice Address - State:PA
Practice Address - Zip Code:19460-4342
Practice Address - Country:US
Practice Address - Phone:610-933-8110
Practice Address - Fax:610-933-7451
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC003606101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional