Provider Demographics
NPI:1093372013
Name:BARGER CLEMENTS, CHELSEA RAYE (LPCC)
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:RAYE
Last Name:BARGER CLEMENTS
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3932
Mailing Address - Street 2:
Mailing Address - City:WEST SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42564-3932
Mailing Address - Country:US
Mailing Address - Phone:606-401-2966
Mailing Address - Fax:606-244-4111
Practice Address - Street 1:600 MONTICELLO ST STE 2
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42501-2974
Practice Address - Country:US
Practice Address - Phone:606-401-2966
Practice Address - Fax:606-244-4111
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-24
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY272603101YM0800X
KY244304101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100634510Medicaid