Provider Demographics
NPI:1598221764
Name:WINEGAR, CHELSEY MAREE
Entity Type:Individual
Prefix:
First Name:CHELSEY
Middle Name:MAREE
Last Name:WINEGAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9678 S 700 E STE 102
Mailing Address - Street 2:
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84070-3593
Mailing Address - Country:US
Mailing Address - Phone:801-576-6444
Mailing Address - Fax:
Practice Address - Street 1:9678 S 700 E STE 102
Practice Address - Street 2:
Practice Address - City:SANDY
Practice Address - State:UT
Practice Address - Zip Code:84070-3593
Practice Address - Country:US
Practice Address - Phone:801-576-6444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-13
Last Update Date:2019-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT4986494-3503104100000X
104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker