Provider Demographics
NPI:1558385864
Name:ARCHAMBAULT SELVES, PAULA M (LMSW)
Entity type:Individual
Prefix:
First Name:PAULA
Middle Name:M
Last Name:ARCHAMBAULT SELVES
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:PAULA
Other - Middle Name:
Other - Last Name:ARCHAMBAULT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW, LMSW
Mailing Address - Street 1:6531 N SEYMOUR RD
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:MI
Mailing Address - Zip Code:48433-1007
Mailing Address - Country:US
Mailing Address - Phone:810-964-9242
Mailing Address - Fax:
Practice Address - Street 1:1507 E PIERSON RD
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:MI
Practice Address - Zip Code:48433-1816
Practice Address - Country:US
Practice Address - Phone:810-964-9242
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2022-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010841911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical