Provider Demographics
NPI:1700458544
Name:SELLIS, DENNIS (CSWI)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:
Last Name:SELLIS
Suffix:
Gender:M
Credentials:CSWI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:352 S DENVER ST STE 315
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84111-3054
Mailing Address - Country:US
Mailing Address - Phone:801-520-7938
Mailing Address - Fax:
Practice Address - Street 1:352 S DENVER ST STE 315
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84111-3054
Practice Address - Country:US
Practice Address - Phone:801-309-6980
Practice Address - Fax:800-528-1208
Is Sole Proprietor?:No
Enumeration Date:2021-07-12
Last Update Date:2022-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health