Provider Demographics
NPI:1295240216
Name:SELL, KATIE S (CADC)
Entity type:Individual
Prefix:
First Name:KATIE
Middle Name:S
Last Name:SELL
Suffix:
Gender:F
Credentials:CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1018
Mailing Address - Street 2:
Mailing Address - City:CARIBOU
Mailing Address - State:ME
Mailing Address - Zip Code:04736-1018
Mailing Address - Country:US
Mailing Address - Phone:207-498-6431
Mailing Address - Fax:
Practice Address - Street 1:14 STEVES LN
Practice Address - Street 2:
Practice Address - City:MARSHFIELD
Practice Address - State:ME
Practice Address - Zip Code:04654-5045
Practice Address - Country:US
Practice Address - Phone:207-255-0996
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-13
Last Update Date:2017-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECAC6327101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor