Organization
OREGON MENTAL HEALTH SVS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY JOAN SELLA LCSW (CLINICAL SOCIAL WORKER/CLINIC OWNER)
(608) 835-5050
Entity
Organization
Contact information
Practice address
602 PLEASANT OAK DR, OREGON, WI 53575
(608) 835-5050
(608) 835-5050
Mailing address
602 PLEASANT OAK DR, OREGON, WI 53575
(608) 835-5050
(608) 835-5050
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2513 CERTIFICATE
MENTAL HEALTH OUTPUT
WI
05
—
42235500
—
WI
Enumeration date
10/25/2006
Last updated
09/11/2025
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