| Provider / Organization | NPI | Date Certified |
|---|---|---|
| JAN SELANDER | 1396138350 | 2023-04-20 |
Jan M Selander [F] graduated in 2009 and primarily specializes in Clinical Social Worker.
Jan Selander is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1396138350. Registration indicates Jan Selander is a provider of access to mental health/behavioral health providers services with a specialization in Behavioral Health & Social Service Providers, Social Worker (Behavioral Health & Social Service Providers, Social Worker) (Social Worker, ) (Behavioral Health/Substance Abuse/Psychiatry, ) (Social Worker, Behavioral Health & Social Service Providers) Access to Mental Health/Behavioral Health Providers (Behavioral Health & Social Service Providers, Social Worker) (Behavioral Health & Social Service Providers, Social Worker) (Social Worker: Clinical, ) (Behavioral Health/Substance Abuse/Psychiatry, ) (Social Worker Clinical, Behavioral Health & Social Service Providers) (Social Worker, )
| PECOS ID | 9638473887 |
| Registration | PART-B:Y DME:Y HHA:N PMD:N |
| Entity Type | Individual |
| Provider Name | Jan Selander LCSW |
| Practice Office Address | 6735 VISTAGREEN WAY STE 210 ROCKFORD, IL US |
| Practice Office Telephone | 8155206972 |
| Practice Office Fax | 8159046419 |
| Mailing Address | 6735 VISTAGREEN WAY STE 210 ROCKFORD, IL 611075654 US |
| Business Telephone | 8155206972 |
| Business Fax | 8159046419 |
| Address | City / State | Phone / Fax |
|---|---|---|
| 4615 E State St Suite 130 | Rockford, IL 611082100 | 8153913055 |
| Code | Practice | License No State |
|---|---|---|
| 104100000X | Access to Mental Health/Behavioral Health Providers Behavioral Health & Social Service Providers Social Worker Behavioral Health & Social Service Providers Social Worker Social Worker Behavioral Health/Substance Abuse/Psychiatry Social Worker Behavioral Health & Social Service Providers | 150.012163
IL |
| 1041C0700X PRIMARY | Access to Mental Health/Behavioral Health Providers Behavioral Health & Social Service Providers Social Worker Behavioral Health & Social Service Providers Social Worker Social Worker: Clinical Behavioral Health/Substance Abuse/Psychiatry Social Worker Clinical Behavioral Health & Social Service Providers Social Worker | 149017603
IL |