Provider Demographics
NPI:1689760738
Name:BRIERLY, CHELSEA C (MA MFT)
Entity Type:Individual
Prefix:MS
First Name:CHELSEA
Middle Name:C
Last Name:BRIERLY
Suffix:
Gender:F
Credentials:MA MFT
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 2892
Mailing Address - Street 2:
Mailing Address - City:STATELINE
Mailing Address - State:NV
Mailing Address - Zip Code:89449
Mailing Address - Country:US
Mailing Address - Phone:530-208-6109
Mailing Address - Fax:530-542-1511
Practice Address - Street 1:2489 LAKE TAHOE BLVD
Practice Address - Street 2:STE 30
Practice Address - City:SOUTH LAKE TAHOE
Practice Address - State:CA
Practice Address - Zip Code:96150
Practice Address - Country:US
Practice Address - Phone:530-208-6109
Practice Address - Fax:530-542-1511
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC41561103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist