Provider Demographics
NPI:1326525619
Name:GOLIAS, CHELSEA RAE (CDPT)
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:RAE
Last Name:GOLIAS
Suffix:
Gender:F
Credentials:CDPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 4TH AVE E STE 301
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98501-1188
Mailing Address - Country:US
Mailing Address - Phone:360-534-7986
Mailing Address - Fax:360-534-9595
Practice Address - Street 1:203 4TH AVE E STE 301
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98501-1188
Practice Address - Country:US
Practice Address - Phone:360-534-7986
Practice Address - Fax:360-534-9595
Is Sole Proprietor?:No
Enumeration Date:2018-07-19
Last Update Date:2020-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACO60816670101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)