Provider Demographics
NPI:1578124368
Name:SWEAT, CHELSEY (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CHELSEY
Middle Name:
Last Name:SWEAT
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4212 CORAL PARK DR
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:GA
Mailing Address - Zip Code:31520-3016
Mailing Address - Country:US
Mailing Address - Phone:123-428-8759
Mailing Address - Fax:912-342-8016
Practice Address - Street 1:1701 BOULEVARD SQ STE F
Practice Address - Street 2:
Practice Address - City:WAYCROSS
Practice Address - State:GA
Practice Address - Zip Code:31501-8022
Practice Address - Country:US
Practice Address - Phone:123-428-8759
Practice Address - Fax:912-342-8016
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-24
Last Update Date:2022-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPCET002906235Z00000X
GASLP011355235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist