Provider Demographics
NPI:1467970111
Name:MENG, CHELSEA KALYNN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:CHELSEA
Middle Name:KALYNN
Last Name:MENG
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:MISS
Other - First Name:CHELSEA
Other - Middle Name:KALYNN
Other - Last Name:KOCIUBA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 634
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:OH
Mailing Address - Zip Code:44202-0634
Mailing Address - Country:US
Mailing Address - Phone:440-546-0048
Mailing Address - Fax:888-828-2326
Practice Address - Street 1:8180 BRECKSVILLE RD # 115
Practice Address - Street 2:
Practice Address - City:BRECKSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44141
Practice Address - Country:US
Practice Address - Phone:440-546-0048
Practice Address - Fax:888-828-2326
Is Sole Proprietor?:No
Enumeration Date:2017-09-01
Last Update Date:2018-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHP.07727103G00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical