Provider Demographics
NPI:1003055880
Name:TELSEY, CECELIA M (MS)
Entity Type:Individual
Prefix:MS
First Name:CECELIA
Middle Name:M
Last Name:TELSEY
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6766 108 STREET
Mailing Address - Street 2:D 11
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-2999
Mailing Address - Country:US
Mailing Address - Phone:718-575-1035
Mailing Address - Fax:
Practice Address - Street 1:6766 108 STREET
Practice Address - Street 2:D-11
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-2999
Practice Address - Country:US
Practice Address - Phone:718-575-1035
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-18
Last Update Date:2009-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003424101Y00000X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health