Provider Demographics
NPI:1215766209
Name:SELLERS, ANGIE M (MA,LAPC)
Entity type:Individual
Prefix:
First Name:ANGIE
Middle Name:M
Last Name:SELLERS
Suffix:
Gender:F
Credentials:MA,LAPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 261
Mailing Address - Street 2:
Mailing Address - City:JONESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17038-0261
Mailing Address - Country:US
Mailing Address - Phone:717-805-5519
Mailing Address - Fax:
Practice Address - Street 1:100 E MARKET ST
Practice Address - Street 2:
Practice Address - City:JONESTOWN
Practice Address - State:PA
Practice Address - Zip Code:17038-9514
Practice Address - Country:US
Practice Address - Phone:717-805-5519
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-29
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAPC000256101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional