Selene Aguayo Gisholt, M.A., L.M.H.C.
Individual provider Active NPI Mental Health Counselor · Lexington, MA
NPI 1124497656 · NPPES record last updated Sep 15, 2015
Key facts
- NPI
- 1124497656
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- 5166 (MA)
- Practice address
- 187 Spring St
Lexington, MA 02421-8030 - Phone
- (781) 861-7081
- Fax
- (781) 861-3625
- NPI assigned
- Sep 15, 2015
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5166 | MA | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 5166 | MA | Yes |
Addresses
Primary practice location
187 Spring St
Lexington, MA 02421-8030
Mailing address
187 Spring St
Lexington, MA 02421-8030
Phone (781) 861-7081
Other providers in Lexington, MA
- Jane Deitz Adolph
- Adriana Digrande Ms Cccslp PLLP
- Advocates, Inc.
- Nishtha Agarwal
- Johnna Aggelikas
- Loren M Aguiar
- Anthony Robert Aguirre
- Hyung-Jun Ahn
- Olusegun Emmanuel Aina
- Patrick Aker
All providers in Lexington, MA · Mental Health Counselor in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 15, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.