Provider Demographics
NPI:1275048779
Name:SAUNDERS, CHELSEA ELISE (LSW)
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:ELISE
Last Name:SAUNDERS
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4288 PIMLICO PL
Mailing Address - Street 2:
Mailing Address - City:HUBER HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:45424-3884
Mailing Address - Country:US
Mailing Address - Phone:937-499-0288
Mailing Address - Fax:
Practice Address - Street 1:2640 SAINT CHARLES AVE
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45410-3147
Practice Address - Country:US
Practice Address - Phone:937-586-0435
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-06
Last Update Date:2021-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1501387104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty