Provider Demographics
NPI:1376241646
Name:BEY-MOON, CHELSEA
Entity Type:Individual
Prefix:MRS
First Name:CHELSEA
Middle Name:
Last Name:BEY-MOON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CHELSEA
Other - Middle Name:
Other - Last Name:BEY-MOON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:354 MERRIMACK ST STE 395
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01843-1755
Mailing Address - Country:US
Mailing Address - Phone:774-206-1125
Mailing Address - Fax:
Practice Address - Street 1:354 MERRIMACK ST STE 395
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01843-1755
Practice Address - Country:US
Practice Address - Phone:774-206-1125
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-16
Last Update Date:2023-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLISW156861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLISW15686OtherDEPARTMENT OF HEALTH