Provider Information for 1629239439
The following NPI(s) contain information matching your search criteria. Please select the NPI to view all the data associated with the NPI.
Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know
GABRIEL ETHAN SELDESS LMFT, LPC
Sex: Male
NPI: 1629239439
Last Updated: 2016-11-08
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1629239439 | ||||||||||||||||||||
| Enumeration Date | 2008-06-24 | ||||||||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||||||||
| Sole Proprietor | NO | ||||||||||||||||||||
| Status | Active | ||||||||||||||||||||
| Mailing Address | 5100 N. RAVENSWOOD SUITE 207 CHICAGO, IL 60640 United States Phone: 336-776-8312 | Fax: | ||||||||||||||||||||
| Primary Practice Address | 5100 N. RAVENSWOOD SUITE 207 CHICAGO, IL 60640 United States Phone: 336-776-8312 | Fax: | ||||||||||||||||||||
| Secondary Practice Address(es) | |||||||||||||||||||||
| Health Information Exchange |
| ||||||||||||||||||||
| Other Identifiers |
| ||||||||||||||||||||
| Taxonomy |
|