Selena Estes-Walls, LPC-S

Individual provider Active NPI Mental Health Counselor · Philadelphia, MS

NPI 1699869693 · NPPES record last updated Dec 10, 2014

Key facts

NPI
1699869693
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
License
1183 (MS)
Practice address
1120 E Main
Suite 21
Philadelphia, MS 39350
Phone
(662) 803-7285
Fax
(601) 568-5016
NPI assigned
Oct 3, 2006
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
1183MSMDMental Health Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 1183 MS Yes

Addresses

Primary practice location

1120 E Main
Suite 21
Philadelphia, MS 39350

Mailing address

142 McCullough Rd
Louisville, MS 39339
Phone (662) 803-7285

Other providers in Philadelphia, MS

All providers in Philadelphia, MS · Mental Health Counselor in Mississippi

Sources for this page

Verify at the official NPI Registry.