Provider Demographics
NPI:1295245819
Name:SPROTT, SELENA DIONNE (LPCC)
Entity type:Individual
Prefix:MS
First Name:SELENA
Middle Name:DIONNE
Last Name:SPROTT
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3450 W CENTRAL AVE STE 350
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43606-1418
Mailing Address - Country:US
Mailing Address - Phone:419-407-5498
Mailing Address - Fax:419-407-5097
Practice Address - Street 1:3450 W CENTRAL AVE STE 350
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43606-1418
Practice Address - Country:US
Practice Address - Phone:419-407-5498
Practice Address - Fax:419-407-5097
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-10
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.2102261101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health