Provider Demographics
NPI:1407581747
Name:DEAN, SELECIA (LSCSW)
Entity type:Individual
Prefix:
First Name:SELECIA
Middle Name:
Last Name:DEAN
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 1:9415 E HARRY ST STE 403
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67207-5083
Mailing Address - Country:US
Mailing Address - Phone:910-978-1282
Mailing Address - Fax:316-202-8215
Practice Address - Street 1:9415 E HARRY ST STE 403
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67207-5083
Practice Address - Country:US
Practice Address - Phone:316-530-7480
Practice Address - Fax:316-202-8215
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-20
Last Update Date:2025-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS069281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS06928OtherLSCSW
KS30004834530002Medicaid