Provider Demographics
NPI:1538725775
Name:SAMES, CHELSEA RENEE (BA, RBT)
Entity type:Individual
Prefix:
First Name:CHELSEA
Middle Name:RENEE
Last Name:SAMES
Suffix:
Gender:F
Credentials:BA, RBT
Other - Prefix:
Other - First Name:CHELSEA
Other - Middle Name:RENEE
Other - Last Name:MCMANAWAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 931142
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:31193-6135
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:141 N EAGLE CREEK DR STE 103
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-1832
Practice Address - Country:US
Practice Address - Phone:270-632-6676
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-14
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RBT-19-86100106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
RBT-19-86100OtherRBT