Provider Demographics
NPI:1992029805
Name:SELL, JESSIE MERRINDA (LMFT)
Entity Type:Individual
Prefix:
First Name:JESSIE
Middle Name:MERRINDA
Last Name:SELL
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 1:270 HORIZON DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-4922
Mailing Address - Country:US
Mailing Address - Phone:919-845-0623
Mailing Address - Fax:919-488-1716
Practice Address - Street 1:270 HORIZON DR
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-4922
Practice Address - Country:US
Practice Address - Phone:919-845-0623
Practice Address - Fax:919-488-1716
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-22
Last Update Date:2012-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1268106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist