Provider Demographics
NPI:1942269907
Name:SELIGER, SHERYL ANNE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:SHERYL
Middle Name:ANNE
Last Name:SELIGER
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 1:1446 S 900 E
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84105-2344
Mailing Address - Country:US
Mailing Address - Phone:801-556-8760
Mailing Address - Fax:801-467-0660
Practice Address - Street 1:1446 S 900 E
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84105-2344
Practice Address - Country:US
Practice Address - Phone:801-556-8760
Practice Address - Fax:801-467-0660
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-20
Last Update Date:2014-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT277172-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT000077046Medicare ID - Type Unspecified
UTP26929Medicare UPIN