Provider Demographics
NPI:1407329733
Name:MYERS, CHELSEA LESLIE (MSW)
Entity Type:Individual
Prefix:MRS
First Name:CHELSEA
Middle Name:LESLIE
Last Name:MYERS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5279 EDUCATION DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45331-9759
Mailing Address - Country:US
Mailing Address - Phone:937-564-2081
Mailing Address - Fax:
Practice Address - Street 1:5279 EDUCATION DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:OH
Practice Address - Zip Code:45331-9759
Practice Address - Country:US
Practice Address - Phone:937-564-2081
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-09
Last Update Date:2019-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.13025881041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool