Provider Demographics
NPI:1689079543
Name:RAGSDALE, CHELSEA (LSW)
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:
Last Name:RAGSDALE
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1255 W BELDEN AVE
Mailing Address - Street 2:APT. 8A
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-3128
Mailing Address - Country:US
Mailing Address - Phone:217-390-4311
Mailing Address - Fax:
Practice Address - Street 1:3047 N LINCOLN AVE
Practice Address - Street 2:SUITE 400
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-4999
Practice Address - Country:US
Practice Address - Phone:217-390-4311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-04
Last Update Date:2014-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150.014427104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker