Provider Demographics
NPI:1417737008
Name:WEGENER, CHELSEA JOAN (LPC)
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:JOAN
Last Name:WEGENER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20306 FOSSIL VALLEY LN
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-5181
Mailing Address - Country:US
Mailing Address - Phone:217-621-0286
Mailing Address - Fax:
Practice Address - Street 1:20306 FOSSIL VALLEY LN
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433-5181
Practice Address - Country:US
Practice Address - Phone:217-621-0286
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-02
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX82422101Y00000X
WI10643-125101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor