Provider Demographics
NPI:1124536099
Name:STULTZ, CHELSEY L (LPC)
Entity Type:Individual
Prefix:
First Name:CHELSEY
Middle Name:L
Last Name:STULTZ
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2504 VIA LINDA DR
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66047-3323
Mailing Address - Country:US
Mailing Address - Phone:913-669-5730
Mailing Address - Fax:
Practice Address - Street 1:2504 VIA LINDA DR
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66047-3323
Practice Address - Country:US
Practice Address - Phone:913-669-5730
Practice Address - Fax:913-669-5730
Is Sole Proprietor?:No
Enumeration Date:2018-01-13
Last Update Date:2018-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2226101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional