Individual provider Active NPI

Mary Jo Selbe, LPC

  • Mental Health Counselor
  • Charleston, WV
National Provider Identifier
1770090011
Registry record updated Oct 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
2333 Issued in WV
Practice address
305 20TH St SE
Charleston, WV 25304-1003
Phone
(304) 619-8715
NPI assigned
Jan 9, 2018
Reactivated
Oct 10, 2024
Last updated
Oct 10, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 2333 WV Primary

Addresses

Primary practice location

305 20TH St SE
Charleston, WV 25304-1003

Mailing address

4708 Venable Ave Apt 3
Charleston, WV 25304-1960
Phone (304) 619-8715

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250303000451 WV Practitioner - Mental Health Counselor 3375064710 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
THS Physician Partners IncGroup PAC ID 9537316393, 366 clinicians

Practice addresses (Care Compare)

333 Laidley St
Charleston, WV 25301-1614
Phone (304) 766-4560

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2333WVMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
THS Physician Partners Inc CurrentSince Nov 8, 2024 Accepting new patients

Locations

L3539
Columbus, OH 43260
Phone (304) 414-4800

333 Laidley St
#4E
Charleston, WV 25301

333 Laidley St
Fl 4E
Charleston, WV 25301
Phone (304) 766-4560

4605 Maccorkle Ave SW
South Charleston, WV 25309
Phone (304) 414-4800

500 Poplar St
Ste 204
South Charleston, WV 25309
Phone (304) 414-2895

Organizations & group practices 1

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

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1515456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728518400000",
    "number": "1770090011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4708 VENABLE AVE APT 3",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253041960",
            "telephone_number": "304-619-8715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 20TH ST SE",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253041003",
            "telephone_number": "304-619-8715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELBE",
        "first_name": "MARY",
        "middle_name": "JO",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-09",
        "last_updated": "2024-10-10",
        "certification_date": "2020-01-30",
        "deactivation_date": "2020-01-30",
        "reactivation_date": "2024-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WV",
            "license": "2333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

Verify at the official NPI Registry.