Provider Demographics
NPI:1437659539
Name:BURNS, CHELSEA JEANNETTE (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:JEANNETTE
Last Name:BURNS
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 SAGO LN
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28117-4369
Mailing Address - Country:US
Mailing Address - Phone:704-746-9698
Mailing Address - Fax:
Practice Address - Street 1:1669 NORWOOD RD
Practice Address - Street 2:
Practice Address - City:STATESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28677-8201
Practice Address - Country:US
Practice Address - Phone:704-746-9698
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-15
Last Update Date:2019-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
235Z00000X
NC12796235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist