Provider Demographics
NPI:1528548435
Name:TOLLETT, CHELSEA DAYE (LPC)
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:DAYE
Last Name:TOLLETT
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 1:327 OLD CENTER POINT RD
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:71852-8504
Mailing Address - Country:US
Mailing Address - Phone:870-200-2775
Mailing Address - Fax:
Practice Address - Street 1:201 E HEMPSTEAD ST STE 1
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:AR
Practice Address - Zip Code:71852-2518
Practice Address - Country:US
Practice Address - Phone:870-845-3110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-20
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA1809131101YM0800X
AR171M00000X
ARP2103172101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator