Provider Demographics
NPI:1437895414
Name:MARTELL, CHELSEA T (LCSW)
Entity type:Individual
Prefix:MS
First Name:CHELSEA
Middle Name:T
Last Name:MARTELL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 AUSTRALIAN AVE
Mailing Address - Street 2:
Mailing Address - City:RIVIERA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33404-6635
Mailing Address - Country:US
Mailing Address - Phone:561-842-5814
Mailing Address - Fax:
Practice Address - Street 1:3879 BYRON DR
Practice Address - Street 2:
Practice Address - City:RIVIERA BEACH
Practice Address - State:FL
Practice Address - Zip Code:33404-3311
Practice Address - Country:US
Practice Address - Phone:561-842-5814
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-11
Last Update Date:2022-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL19618101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor