Provider Demographics
NPI:1386232049
Name:CHELSEA MANZON LCSWC, APC
Entity Type:Organization
Organization Name:CHELSEA MANZON LCSWC, APC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHELSEA
Authorized Official - Middle Name:
Authorized Official - Last Name:MANZON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSWC
Authorized Official - Phone:919-381-2462
Mailing Address - Street 1:9199 REISTERSTOWN RD STE 202B
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-4579
Mailing Address - Country:US
Mailing Address - Phone:919-381-2462
Mailing Address - Fax:
Practice Address - Street 1:9199 REISTERSTOWN RD STE 202B
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-4579
Practice Address - Country:US
Practice Address - Phone:919-381-2462
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-07
Last Update Date:2021-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD22834OtherSTATE LICENSE