Provider Demographics
NPI:1811050099
Name:SELOVER, REBECCA (LMHC)
Entity type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:
Last Name:SELOVER
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:672 LAKEWORTH CIR
Mailing Address - Street 2:
Mailing Address - City:HEATHROW
Mailing Address - State:FL
Mailing Address - Zip Code:32746-5369
Mailing Address - Country:US
Mailing Address - Phone:407-829-7308
Mailing Address - Fax:
Practice Address - Street 1:187 E CRYSTAL LAKE AVE
Practice Address - Street 2:STE. 2005
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-3207
Practice Address - Country:US
Practice Address - Phone:407-617-2843
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 8871101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health