Provider Demographics
NPI:1174003057
Name:ASHTON, CHELSEA LYNN (LCDC-I)
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:LYNN
Last Name:ASHTON
Suffix:
Gender:F
Credentials:LCDC-I
Other - Prefix:
Other - First Name:CHELSEA
Other - Middle Name:
Other - Last Name:WILSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3553 W HOUSTON HARTE EXPY
Mailing Address - Street 2:
Mailing Address - City:SAN ANGELO
Mailing Address - State:TX
Mailing Address - Zip Code:76901-2664
Mailing Address - Country:US
Mailing Address - Phone:325-224-3481
Mailing Address - Fax:
Practice Address - Street 1:3553 W HOUSTON HARTE EXPY
Practice Address - Street 2:
Practice Address - City:SAN ANGELO
Practice Address - State:TX
Practice Address - Zip Code:76901-2664
Practice Address - Country:US
Practice Address - Phone:325-224-3481
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-20
Last Update Date:2018-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX40449101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)