Provider Demographics
NPI:1497894331
Name:SELBERG, ANNE KRISTINE (LCPC)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:KRISTINE
Last Name:SELBERG
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:A.
Other - Middle Name:KRISTINE
Other - Last Name:SELBERG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCPC
Mailing Address - Street 1:35 REBECCA LN
Mailing Address - Street 2:
Mailing Address - City:YARMOUTH
Mailing Address - State:ME
Mailing Address - Zip Code:04096-7137
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:35 REBECCA LN
Practice Address - Street 2:
Practice Address - City:YARMOUTH
Practice Address - State:ME
Practice Address - Zip Code:04096-7137
Practice Address - Country:US
Practice Address - Phone:207-233-8949
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2025-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECC4443101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional