Provider Demographics
NPI:1326520230
Name:BHADOURIA, CHELSEY C (LICSW)
Entity Type:Individual
Prefix:
First Name:CHELSEY
Middle Name:C
Last Name:BHADOURIA
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 LIVINGSTON PL
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02842-1429
Mailing Address - Country:US
Mailing Address - Phone:401-654-0097
Mailing Address - Fax:
Practice Address - Street 1:827 N MAIN ST STE 3
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02904-5751
Practice Address - Country:US
Practice Address - Phone:401-235-4170
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-06
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIISW032481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical