Selin Tastan, PH.D.

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Practice address

11020 S Tryon St Ste 408
Charlotte, NC 28273-6662

Phone

(704) 237-4240

NPI assigned

Jan 15, 2011

Reactivated

Dec 6, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Selin Sertgoz Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Carolinas Mental Health, PLLC

  • Mental Health Counselor
  • Charlotte, NC
  • NPI 1023628427
  NPD Authorized official
• Center for Emotional Health

  • Addiction Psychiatry Physician
  • Gastonia, NC
  • NPI 1174922348
  NPD (past)

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

{
    "created_epoch": "1295049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549929600000",
    "number": "1578868907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 HUFF AVE. (KREINBROOK PSYCOLOGICAL SERVICES)",
            "city": "GREENSBURG",
            "state": "PA",
            "postal_code": "15601",
            "telephone_number": "724-836-4662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11020 S TRYON ST STE 408",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282736662",
            "telephone_number": "704-237-4240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TASTAN",
        "first_name": "SELIN",
        "name_prefix": "Mrs.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-01-15",
        "last_updated": "2019-02-12",
        "deactivation_date": "2011-05-18",
        "reactivation_date": "2017-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SELIN",
            "last_name": "SERTGOZ",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Teniece R Tarver
• Danielle Tashakori, PA
• Kristen Tassinari, PTA
• Daniel M Tassone, PHARM.D.
• Tassy Trucks
• Tate Healthcare Serives
• Melissa E Tate-Scruse, ED.D, LCMHCS
• Britannia Elaine Tate, N.P.
• Chandra R Tate, FNP
• Christian Marie Tate, LCSW-A

• Professional Counselor in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Professional Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.