Provider Demographics
NPI:1942533484
Name:TODD, SELINA KAY (LCSW)
Entity Type:Individual
Prefix:MS
First Name:SELINA
Middle Name:KAY
Last Name:TODD
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 1:7945 LE JEUNE DR
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32514-6534
Mailing Address - Country:US
Mailing Address - Phone:850-501-0214
Mailing Address - Fax:850-475-0924
Practice Address - Street 1:7945 LE JEUNE DR
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32514-6534
Practice Address - Country:US
Practice Address - Phone:850-501-0214
Practice Address - Fax:850-475-0924
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-16
Last Update Date:2009-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW59381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical