Provider Demographics
NPI:1558089151
Name:MEANS, CHELSI WINTER (CSW)
Entity Type:Individual
Prefix:
First Name:CHELSI
Middle Name:WINTER
Last Name:MEANS
Suffix:
Gender:F
Credentials:CSW
Other - Prefix:
Other - First Name:CHELSI
Other - Middle Name:WINTER
Other - Last Name:PETERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1812 SHADY LN
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71118-2229
Mailing Address - Country:US
Mailing Address - Phone:442-295-2473
Mailing Address - Fax:
Practice Address - Street 1:2924 KNIGHT ST STE 369
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71105-2413
Practice Address - Country:US
Practice Address - Phone:318-210-0587
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-19
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
LA18166104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA171M00000XMedicaid