Individual
GABRIEL ETHAN SELDESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMFT, LPC
Contact information
Practice address
5100 N. RAVENSWOOD, SUITE 207, CHICAGO, IL 60640
(336) 776-8312
Mailing address
5100 N. RAVENSWOOD, SUITE 207, CHICAGO, IL 60640
(336) 776-8312
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
178.004640
IL
101YP2500X
Professional Counselor
7040
NC
106H00000X
Marriage & Family Therapist
Primary
166.000965
IL
106H00000X
Marriage & Family Therapist
166000965
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6103959
—
NC
Enumeration date
06/24/2008
Last updated
11/08/2016
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