Provider Demographics
NPI:1982581930
Name:SEILTZ, SHELBY
Entity type:Individual
Prefix:
First Name:SHELBY
Middle Name:
Last Name:SEILTZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4335 E ARROWHEAD RD
Mailing Address - Street 2:
Mailing Address - City:MONTICELLO
Mailing Address - State:IN
Mailing Address - Zip Code:47960-7607
Mailing Address - Country:US
Mailing Address - Phone:765-412-9474
Mailing Address - Fax:
Practice Address - Street 1:1 ROBERT EGLY DR
Practice Address - Street 2:
Practice Address - City:ROSSVILLE
Practice Address - State:IN
Practice Address - Zip Code:46065-9664
Practice Address - Country:US
Practice Address - Phone:765-379-2990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-20
Last Update Date:2025-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN000044926103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool