Provider Demographics
NPI:1063015741
Name:KELTER, CHELSEA (MS, BCCT, CCATP)
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:
Last Name:KELTER
Suffix:
Gender:F
Credentials:MS, BCCT, CCATP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:327 DAHLONEGA HWY
Mailing Address - Street 2:SUITE 1902 A
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30040
Mailing Address - Country:US
Mailing Address - Phone:561-379-2493
Mailing Address - Fax:
Practice Address - Street 1:327 DAHLONEGA HWY
Practice Address - Street 2:SUITE 1902 A
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30040
Practice Address - Country:US
Practice Address - Phone:561-379-2493
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-17
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA2152589101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral