Provider Demographics
NPI:1013405604
Name:ESSMEIER, CHELSEY BLAKE
Entity Type:Individual
Prefix:
First Name:CHELSEY
Middle Name:BLAKE
Last Name:ESSMEIER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:606 E STOVALL ST
Mailing Address - Street 2:
Mailing Address - City:DODSON
Mailing Address - State:LA
Mailing Address - Zip Code:71422-3652
Mailing Address - Country:US
Mailing Address - Phone:972-268-0086
Mailing Address - Fax:
Practice Address - Street 1:904 DEVILLE LN
Practice Address - Street 2:
Practice Address - City:RUSTON
Practice Address - State:LA
Practice Address - Zip Code:71270-6313
Practice Address - Country:US
Practice Address - Phone:318-242-4650
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-29
Last Update Date:2020-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
7463101YM0800X
101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health