Provider Demographics
NPI:1902886112
Name:SELLECK, MARTHA E (MSW, LSW)
Entity Type:Individual
Prefix:MRS
First Name:MARTHA
Middle Name:E
Last Name:SELLECK
Suffix:
Gender:F
Credentials:MSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:342 DUQUESNE WAY
Mailing Address - Street 2:
Mailing Address - City:SEWICKLEY
Mailing Address - State:PA
Mailing Address - Zip Code:15143-1458
Mailing Address - Country:US
Mailing Address - Phone:412-420-4095
Mailing Address - Fax:
Practice Address - Street 1:342 DUQUESNE WAY
Practice Address - Street 2:
Practice Address - City:SEWICKLEY
Practice Address - State:PA
Practice Address - Zip Code:15143-1458
Practice Address - Country:US
Practice Address - Phone:412-420-4095
Practice Address - Fax:412-741-8260
Is Sole Proprietor?:No
Enumeration Date:2006-01-23
Last Update Date:2020-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0159951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical