Provider Demographics
NPI:1962541607
Name:SELIM, WAFAIE MOUNIR (LSW)
Entity type:Individual
Prefix:MR
First Name:WAFAIE
Middle Name:MOUNIR
Last Name:SELIM
Suffix:
Gender:M
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4970 BELMONT AVE
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44505-1018
Mailing Address - Country:US
Mailing Address - Phone:330-759-8237
Mailing Address - Fax:
Practice Address - Street 1:4970 BELMONT AVE
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44505-1018
Practice Address - Country:US
Practice Address - Phone:330-759-8237
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS0010926104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker