Provider Demographics
NPI:1629795562
Name:HOLDEN, CHELSEY L (PHD, LMFT, LPC)
Entity Type:Individual
Prefix:DR
First Name:CHELSEY
Middle Name:L
Last Name:HOLDEN
Suffix:
Gender:F
Credentials:PHD, LMFT, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 17083
Mailing Address - Street 2:
Mailing Address - City:HATTIESBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39404
Mailing Address - Country:US
Mailing Address - Phone:601-266-5254
Mailing Address - Fax:
Practice Address - Street 1:12337 ASHLEY DR STE C
Practice Address - Street 2:
Practice Address - City:GULFPORT
Practice Address - State:MS
Practice Address - Zip Code:39503-2753
Practice Address - Country:US
Practice Address - Phone:601-288-1577
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-21
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MST0476106H00000X
MS2266101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist