Provider Demographics
NPI:1003066945
Name:GAMBLES, CHELSEA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:CHELSEA
Middle Name:
Last Name:GAMBLES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MISS
Other - First Name:CHELSEA
Other - Middle Name:
Other - Last Name:KUNZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:415 W 2100 N
Mailing Address - Street 2:
Mailing Address - City:CEDAR CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84721-7149
Mailing Address - Country:US
Mailing Address - Phone:435-477-2280
Mailing Address - Fax:
Practice Address - Street 1:777 W CENTER ST
Practice Address - Street 2:
Practice Address - City:MIDVALE
Practice Address - State:UT
Practice Address - Zip Code:84047-7148
Practice Address - Country:US
Practice Address - Phone:801-255-6881
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-29
Last Update Date:2011-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT702046835021041C0700X
UT702046835011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical