Provider Demographics
NPI:1386012706
Name:HOPPERSTAD, CHELSIE (LCSW)
Entity Type:Individual
Prefix:
First Name:CHELSIE
Middle Name:
Last Name:HOPPERSTAD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1707 CEYLON ST
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80011-5237
Mailing Address - Country:US
Mailing Address - Phone:720-299-1221
Mailing Address - Fax:303-933-8216
Practice Address - Street 1:8120 SHERIDAN BLVD STE 207
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80003-6104
Practice Address - Country:US
Practice Address - Phone:720-729-7910
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-02
Last Update Date:2019-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9924087101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO4577069Medicaid