Active NPI
Gary Selbert, LPC
- Professional Counselor
- Potosi, MO
National Provider Identifier
1073042313
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- CS0001519
- Practice address
- 24 Southtowne
Potosi, MO 63664-5729 - Phone
- (573) 438-3733
- Fax
- (573) 438-0046
- NPI assigned
- Jun 9, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | CS0001519 | MO | Primary |
Addresses
Primary practice location
24 Southtowne
Potosi, MO 63664-5729
Mailing address
24 Southtowne
Potosi, MO 63664-5729
Phone (573) 438-3733
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CS0001519 | MO | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1496966400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1496966400000",
"number": "1073042313",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24 SOUTHTOWNE",
"city": "POTOSI",
"state": "MO",
"postal_code": "636645729",
"telephone_number": "573-438-3733",
"fax_number": "573-438-0046"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24 SOUTHTOWNE",
"city": "POTOSI",
"state": "MO",
"postal_code": "636645729",
"telephone_number": "573-438-3733",
"fax_number": "573-438-0046"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SELBERT",
"first_name": "GARY",
"name_prefix": "Mr.",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-06-09",
"last_updated": "2017-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MO",
"license": "CS0001519",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Potosi, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.