Provider Demographics
NPI:1639862212
Name:SMITH, CHELSEA T (LPCA)
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:T
Last Name:SMITH
Suffix:
Gender:F
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4229 BARDSTOWN RD STE 204
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40218-4271
Mailing Address - Country:US
Mailing Address - Phone:502-936-6546
Mailing Address - Fax:502-509-0617
Practice Address - Street 1:4229 BARDSTOWN RD STE 204
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40218-4271
Practice Address - Country:US
Practice Address - Phone:502-936-6546
Practice Address - Fax:502-509-0617
Is Sole Proprietor?:No
Enumeration Date:2023-05-31
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY280689101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health