Provider Demographics
NPI:1598208324
Name:YAMAGUCHI, CHELSEA ANN (MA, LPCC)
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:ANN
Last Name:YAMAGUCHI
Suffix:
Gender:F
Credentials:MA, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2384 RIDGE CIRCLE DR
Mailing Address - Street 2:UNIT 10
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81507-4609
Mailing Address - Country:US
Mailing Address - Phone:970-208-3503
Mailing Address - Fax:
Practice Address - Street 1:2384 RIDGE CIRCLE DR
Practice Address - Street 2:UNIT 10
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81507-4609
Practice Address - Country:US
Practice Address - Phone:970-208-3503
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-28
Last Update Date:2016-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPCC.0014142101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health