Provider Demographics
NPI:1841723533
Name:SELLERS, KATHI
Entity type:Individual
Prefix:
First Name:KATHI
Middle Name:
Last Name:SELLERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3683 S FIRST ST
Mailing Address - Street 2:
Mailing Address - City:JENA
Mailing Address - State:LA
Mailing Address - Zip Code:71342-6409
Mailing Address - Country:US
Mailing Address - Phone:318-715-8068
Mailing Address - Fax:
Practice Address - Street 1:PHOENIX FAMILY LIFE CENTER
Practice Address - Street 2:3683 S FIRST ST
Practice Address - City:JENA
Practice Address - State:LA
Practice Address - Zip Code:71342-7134
Practice Address - Country:US
Practice Address - Phone:318-992-2263
Practice Address - Fax:318-992-2267
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-10
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health