Provider Demographics
NPI:1376393801
Name:ELSTON, CHELSEA (CADC)
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:
Last Name:ELSTON
Suffix:
Gender:F
Credentials:CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 FRANKLIN ST STE 1A
Mailing Address - Street 2:
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401-4973
Mailing Address - Country:US
Mailing Address - Phone:207-616-0705
Mailing Address - Fax:
Practice Address - Street 1:115 FRANKLIN ST STE 1A
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-4973
Practice Address - Country:US
Practice Address - Phone:207-616-0705
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-26
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECAC8731101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)