MS. AVA ELIZABETH SELKE (NPI# 1194215970) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194215970 |
| Entity Type | Individual |
| Full Name | MS. AVA ELIZABETH SELKE |
| Credential | MS, TLLP |
| Practice Address |
6549 Town Center Dr Ste A Clarkston MI 48346-4824 |
| Practice Telephone | 2486206400 |
| Mailing Telephone | 2486206400 |
| Enumeration Date | 2018-05-16 |
| Last Update Date | 2020-04-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
6362001113 | MI | Behavioral Health & Social Service Providers |
| N | 103TC0700X |
Psychologist Specialization: Clinical |
6301018366 | MI | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | TAXONOMY | 106S00000X | 01 |
| Street Address |
6549 TOWN CENTER DR STE A |
| City | CLARKSTON |
| State | MI |
| Zip Code | 48346-4824 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346258795 | Monica Sharrice Smith | Psychiatry & Neurology | 6549 Town Center Dr Ste A, Clarkston, MI 48346-4824 | 2006-08-03 |
| 1063013290 | Bradley David Winter | Nurse Practitioner | 6549 Town Center Dr Ste A, Clarkston, MI 48346-4824 | 2020-11-04 |
| 1750981577 | Irene Gwen Voss | Nurse Practitioner | 6549 Town Center Dr Ste A, Clarkston, MI 48346-4824 | 2020-10-30 |
| 1770183956 | Nicholas Lewan | Counselor | 6549 Town Center Dr Ste A, Clarkston, MI 48346-4824 | 2020-10-28 |
| 1124633755 | Gianna Petz | Psychologist | 6549 Town Center Dr Ste A, Clarkston, MI 48346-4824 | 2020-09-10 |
| 1235765041 | Gabrielle Wardlaw-pfaff | Counselor | 6549 Town Center Dr Ste A, Clarkston, MI 48346-4824 | 2020-03-13 |
| 1881225092 | Nikita Bhatnagar | Psychologist | 6549 Town Center Dr Ste A, Clarkston, MI 48346-4824 | 2020-01-28 |
| 1306476809 | Kathleen M Frybarger | Nurse Practitioner | 6549 Town Center Dr Ste A, Clarkston, MI 48346-4824 | 2020-01-23 |
| 1396384392 | Laura Conner | Counselor | 6549 Town Center Dr Ste A, Clarkston, MI 48346-4824 | 2019-12-23 |
| 1659919819 | Mayche Vang-kue | Nurse Practitioner | 6549 Town Center Dr Ste A, Clarkston, MI 48346-4824 | 2019-12-18 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497399745 | Therapy Services of Clarkston LLC | Clinic/Center | 6770 Dixie Highway, Suite 103, Clarkston, MI 48346 | 2019-10-30 |
| 1679041545 | Shiba Lashon Nixon | Registered Nurse | New Oakland, 6549 Town Center Suite A, Clarkston, MI 48346 | 2018-11-08 |
| 1972079655 | Stephanie Gaumer | Social Worker | 6825 Dixie Hwy Ste E, Clarkston, MI 48346 | 2018-10-19 |
| 1912496324 | Regency At Independence Township, LLC | Skilled Nursing Facility | 6211 Stonewood Drive, Clarkston, MI 48346 | 2018-05-02 |
| 1558880591 | 3rd Circle Inc. | Home Health Aide | 39 South Main Street, Ste 2, Clarkston, MI 48346 | 2017-09-11 |
| 1376083246 | Rosemarie Villarreal | Social Worker | 4480 Elmdale Ave, Clarkston, MI 48346 | 2017-02-27 |
| 1932566940 | Syncere Hearts Home Healthcare, LLC | Home Health | 5836 North Marshbank Lane Apt203, Clarkston, MI 48346 | 2016-01-21 |
| 1649635087 | Coddaire & Associates, Inc. | Community/Behavioral Health | 6445 Citation Drive, Suite H, Clarkston, MI 48346 | 2015-12-30 |
| 1013386358 | Victoria Urikh-garcia | Technician, Other | 6510 Town Center Dr Ste E, Clarkston, MI 48346 | 2015-09-16 |
| 1194090993 | Stefanie Pavloski | Counselor | 5701 Bow Pointe Dr., Ste. #380, Clarkston, MI 48346 | 2012-03-13 |
| Find all providers in zip 48346 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780146720 | Jessica Leigh Teeples | Psychologist | 6060 Dixie Hwy Ste H, Clarkston, MI 48346-3476 | 2019-04-01 |
| 1548569049 | Adam R Pasciak | Psychologist | 3604 Clarkston Rd, Clarkston, MI 48348-5215 | 2011-03-23 |
| 1447559513 | Kelli Lynn Shaheen | Psychologist | 5701 Bow Pointe Dr Ste 380, Clarkston, MI 48346-5406 | 2011-03-15 |
| 1336269158 | Richard W Brozovich | Psychologist | 7127 Perry Lake Rd, Clarkston, MI 48346-1655 | 2007-03-29 |
| 1477690576 | Jarod John Fitzgerald | Psychologist | 629 6th St, Clarkston, WA 99403-2010 | 2007-01-30 |
| 1962412601 | Marilyn Cecelia Kimble | Psychologist | 1138 Melrose Dr, Clarkston, GA 30021-2837 | 2006-08-08 |
| 1578587374 | M. Lynn Chambers | Psychologist | 3918 S Ortonville Rd, Suite E, Clarkston, MI 48348-1256 | 2006-07-26 |
| 1376524835 | Joseph Scott Allen Jr. | Psychologist | 7736 Ortonville Rd Ste A, Clarkston, MI 48348-4483 | 2005-11-10 |
| 1124633755 | Gianna Petz | Psychologist | 6549 Town Center Dr Ste A, Clarkston, MI 48346-4824 | 2020-09-10 |
| 1881225092 | Nikita Bhatnagar | Psychologist | 6549 Town Center Dr Ste A, Clarkston, MI 48346-4824 | 2020-01-28 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.