NPIMap

Organization Active NPI

Sel Group

  • Community/Behavioral Health Agency
  • Fayetteville, NC
National Provider Identifier
1407012966
Registry record updated Aug 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
SEL GROUP
Practice address
3612 Cranbrook Dr
Fayetteville, NC 28301
Phone
(336) 285-7173
Fax
(336) 285-7174
NPI assigned
Aug 4, 2008
Last updated
Aug 5, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Keith Funderburk
Title
Owner
Phone
(336) 285-7173

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

3612 Cranbrook Dr
Fayetteville, NC 28301

Mailing address

2618 Battleground Ave Ste a
PMB 266
Greensboro, NC 27408-1925
Phone (336) 285-7173

Other names 1

  • The Social and Emotional Learning Group, PLLC Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171211000414 NC Part B Supplier - Clinic/Group Practice 5092073502 Receives reassigned benefits from 1 practitioner
Practice locations: Greensboro, NC

National Provider Directory

National Provider Directory

Locations

3300 Battleground Ave
Ste 202
Greensboro, NC 27410
Phone (336) 285-7173

3300 Battleground Ave
Ste 304
Greensboro, NC 27410
Phone (336) 285-7173

2618 Battleground Ave
Ste A
Greensboro, NC 27408

Practitioners & affiliated clinicians

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 18

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1217808000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785888000000",
    "number": "1407012966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2618 BATTLEGROUND AVE STE A",
            "address_2": "PMB 266",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274081925",
            "telephone_number": "336-285-7173",
            "fax_number": "336-285-7174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3612 CRANBROOK DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "28301",
            "telephone_number": "336-285-7173",
            "fax_number": "336-285-7174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-04",
        "last_updated": "2026-08-05",
        "certification_date": "2026-08-05",
        "status": "A",
        "authorized_official_last_name": "FUNDERBURK",
        "authorized_official_first_name": "KEITH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "336-285-7173"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Social and Emotional Learning Group, PLLC",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "The Social and Emotional Learning Group, PLLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.