Provider Demographics
NPI:1720678329
Name:SELLAR, DAVID JOHN (MA, LPC, LAC)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:JOHN
Last Name:SELLAR
Suffix:
Gender:M
Credentials:MA, LPC, LAC
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 336
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80151-0336
Mailing Address - Country:US
Mailing Address - Phone:720-469-1114
Mailing Address - Fax:
Practice Address - Street 1:3333 S BANNOCK ST STE 1020
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80110-2512
Practice Address - Country:US
Practice Address - Phone:303-744-3986
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-19
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0017891101YP2500X
COACD.0002036101YA0400X
101YM0800X, 101YA0400X
CO0017321101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9000205622Medicaid