Provider Demographics
NPI:1255458279
Name:SELOVE, SHELLIE MARIE (MS, LPC, LMFT, CST)
Entity type:Individual
Prefix:
First Name:SHELLIE
Middle Name:MARIE
Last Name:SELOVE
Suffix:
Gender:F
Credentials:MS, LPC, LMFT, CST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1246 SALEM CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:STEPHENS CITY
Mailing Address - State:VA
Mailing Address - Zip Code:22655-5546
Mailing Address - Country:US
Mailing Address - Phone:540-868-9000
Mailing Address - Fax:540-868-9064
Practice Address - Street 1:1246 SALEM CHURCH RD
Practice Address - Street 2:
Practice Address - City:STEPHENS CITY
Practice Address - State:VA
Practice Address - Zip Code:22655-5546
Practice Address - Country:US
Practice Address - Phone:540-868-9000
Practice Address - Fax:540-868-9064
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-23
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0717000628106H00000X
VA0701002160101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA084884OtherCOMMUNITY HEALTH