Provider Demographics
NPI:1427716828
Name:SELAH COUNSELING AND WELLNESS P.C.
Entity type:Organization
Organization Name:SELAH COUNSELING AND WELLNESS P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:PARKER
Authorized Official - Last Name:LITTLEFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-342-7503
Mailing Address - Street 1:1019 BRITTA LN
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:IL
Mailing Address - Zip Code:60134-3406
Mailing Address - Country:US
Mailing Address - Phone:312-342-7503
Mailing Address - Fax:
Practice Address - Street 1:1019 BRITTA LN
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:IL
Practice Address - Zip Code:60134-3406
Practice Address - Country:US
Practice Address - Phone:312-342-7503
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-02
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty