Provider Demographics
NPI:1407183916
Name:SELZER, ELYSE A (LSCSW)
Entity type:Individual
Prefix:MRS
First Name:ELYSE
Middle Name:A
Last Name:SELZER
Suffix:
Gender:F
Credentials:LSCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1807 E MARY ST STE 5
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67846-3877
Mailing Address - Country:US
Mailing Address - Phone:620-315-4073
Mailing Address - Fax:620-315-4320
Practice Address - Street 1:1807 E MARY ST STE 5
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:KS
Practice Address - Zip Code:67846-3877
Practice Address - Country:US
Practice Address - Phone:620-315-4073
Practice Address - Fax:620-315-4320
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-05
Last Update Date:2025-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS621101YA0400X
KS42521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)