Provider Demographics
NPI:1861152811
Name:CHELEW, CHELSEA NICHOLLE (LMFT)
Entity type:Individual
Prefix:
First Name:CHELSEA
Middle Name:NICHOLLE
Last Name:CHELEW
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8700 SOHO DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78748-6537
Mailing Address - Country:US
Mailing Address - Phone:858-829-8493
Mailing Address - Fax:
Practice Address - Street 1:8700 SOHO DR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78748-6537
Practice Address - Country:US
Practice Address - Phone:858-829-8493
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-17
Last Update Date:2021-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA129197106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist