Provider Demographics
NPI:1518842624
Name:LANDI, KATHRYN SELLNER (CADC)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:SELLNER
Last Name:LANDI
Suffix:
Gender:F
Credentials:CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:146 9TH FIREROAD
Mailing Address - Street 2:
Mailing Address - City:CHINA
Mailing Address - State:ME
Mailing Address - Zip Code:04358-4170
Mailing Address - Country:US
Mailing Address - Phone:651-769-4477
Mailing Address - Fax:
Practice Address - Street 1:5 COMMERCE DR
Practice Address - Street 2:
Practice Address - City:SKOWHEGAN
Practice Address - State:ME
Practice Address - Zip Code:04976-4823
Practice Address - Country:US
Practice Address - Phone:207-474-8368
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-07
Last Update Date:2025-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MECAC9160101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program