Provider Demographics
NPI:1093089849
Name:PATOW, CHELSEA MARY (LCSW)
Entity Type:Individual
Prefix:MS
First Name:CHELSEA
Middle Name:MARY
Last Name:PATOW
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 1:3450 ERVA ST APT 135
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-6316
Mailing Address - Country:US
Mailing Address - Phone:702-750-6225
Mailing Address - Fax:
Practice Address - Street 1:3161 E WARM SPRINGS RD STE 300
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89120-3144
Practice Address - Country:US
Practice Address - Phone:702-750-6225
Practice Address - Fax:844-965-9650
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-25
Last Update Date:2020-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV8167-C1041C0700X
NVIC-1019104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical