Provider Demographics
NPI:1184480063
Name:HALL, CHELSEA (LMHC)
Entity type:Individual
Prefix:
First Name:CHELSEA
Middle Name:
Last Name:HALL
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3125 49TH ST APT 1A
Mailing Address - Street 2:
Mailing Address - City:WOODSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11377-1314
Mailing Address - Country:US
Mailing Address - Phone:917-302-6129
Mailing Address - Fax:
Practice Address - Street 1:3125 49TH ST APT 1A
Practice Address - Street 2:
Practice Address - City:WOODSIDE
Practice Address - State:NY
Practice Address - Zip Code:11377-1314
Practice Address - Country:US
Practice Address - Phone:917-302-6129
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-27
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009424101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health