Provider Demographics
NPI:1922631654
Name:SELTZER, LAUREN MELISSA (LMFT)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:MELISSA
Last Name:SELTZER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8844
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06532-0844
Mailing Address - Country:US
Mailing Address - Phone:415-652-1782
Mailing Address - Fax:
Practice Address - Street 1:436 ORANGE ST
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-6402
Practice Address - Country:US
Practice Address - Phone:415-652-1782
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-21
Last Update Date:2020-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001417106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist