Provider Demographics
NPI:1215724752
Name:WHITE, SELA JEAN
Entity type:Individual
Prefix:
First Name:SELA
Middle Name:JEAN
Last Name:WHITE
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5238 MORLEY CT
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22032-3917
Mailing Address - Country:US
Mailing Address - Phone:336-306-2944
Mailing Address - Fax:
Practice Address - Street 1:5238 MORLEY CT
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22032-3917
Practice Address - Country:US
Practice Address - Phone:336-306-2944
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-21
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker