Provider Demographics
NPI:1629488614
Name:HILSENDAGER, CHELSEA (LCP)
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:
Last Name:HILSENDAGER
Suffix:
Gender:F
Credentials:LCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6900 E BELLEVIEW AVE STE 205
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-1645
Mailing Address - Country:US
Mailing Address - Phone:303-916-1719
Mailing Address - Fax:
Practice Address - Street 1:6900 E BELLEVIEW AVE STE 205
Practice Address - Street 2:
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-1645
Practice Address - Country:US
Practice Address - Phone:303-916-1719
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-30
Last Update Date:2020-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPSY0004293103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO53175034Medicaid
CO026975OtherKAISER COMMERCIAL NUMBER