Provider Demographics
NPI:1659819266
Name:MELANCON, CHELSEY LYNN (CSW)
Entity Type:Individual
Prefix:MRS
First Name:CHELSEY
Middle Name:LYNN
Last Name:MELANCON
Suffix:
Gender:F
Credentials:CSW
Other - Prefix:MISS
Other - First Name:CHELSEY
Other - Middle Name:LYNN
Other - Last Name:BENNETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4919 CANAL ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70119-5848
Mailing Address - Country:US
Mailing Address - Phone:504-483-9082
Mailing Address - Fax:504-483-9082
Practice Address - Street 1:4919 CANAL ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-5848
Practice Address - Country:US
Practice Address - Phone:504-483-9082
Practice Address - Fax:504-483-9082
Is Sole Proprietor?:No
Enumeration Date:2017-02-02
Last Update Date:2017-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA14081101YP2500X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional