Provider Demographics
NPI:1205495017
Name:SELDA CELEN-DEMIRTAS, PH.D., PLLC
Entity type:Organization
Organization Name:SELDA CELEN-DEMIRTAS, PH.D., PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SELDA
Authorized Official - Middle Name:
Authorized Official - Last Name:CELEN-DEMIRTAS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:781-218-9957
Mailing Address - Street 1:65 GEORGE RD
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01890-1121
Mailing Address - Country:US
Mailing Address - Phone:857-998-7188
Mailing Address - Fax:
Practice Address - Street 1:61 ROSELAND ST STE 2
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02143-3536
Practice Address - Country:US
Practice Address - Phone:857-998-7188
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-06
Last Update Date:2019-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty