Provider Demographics
NPI:1982154209
Name:SELLERS, JES JAMES (PHD)
Entity Type:Individual
Prefix:DR
First Name:JES JAMES
Middle Name:
Last Name:SELLERS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:JAMES
Other - Middle Name:E
Other - Last Name:SELLERS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:2332 DELAWARE DR
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44106-3116
Mailing Address - Country:US
Mailing Address - Phone:216-374-6231
Mailing Address - Fax:
Practice Address - Street 1:2332 DELAWARE DR
Practice Address - Street 2:
Practice Address - City:CLEVELAND HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44106-3116
Practice Address - Country:US
Practice Address - Phone:216-374-6231
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-11
Last Update Date:2019-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3529103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist