Provider Demographics
NPI:1831212646
Name:SELTZER, DICKA A (LCPC, PSA)
Entity type:Individual
Prefix:MS
First Name:DICKA
Middle Name:A
Last Name:SELTZER
Suffix:
Gender:F
Credentials:LCPC, PSA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 E CHESAPEAKE AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21286
Mailing Address - Country:US
Mailing Address - Phone:410-296-7862
Mailing Address - Fax:410-296-7959
Practice Address - Street 1:101 E CHESAPEAKE AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21286
Practice Address - Country:US
Practice Address - Phone:410-296-7862
Practice Address - Fax:410-296-7959
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-08
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD0257101YM0800X, 101YA0400X, 101YP2500X
MDS000050 PSY. ASSIST363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)