Provider Demographics
NPI:1750011854
Name:MILLER, CHELSIE MARIE (LMHC)
Entity Type:Individual
Prefix:
First Name:CHELSIE
Middle Name:MARIE
Last Name:MILLER
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 METATE WAY UNIT A
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-1490
Mailing Address - Country:US
Mailing Address - Phone:605-360-8918
Mailing Address - Fax:
Practice Address - Street 1:4001 OFFICE COURT DR STE 201
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87507-4936
Practice Address - Country:US
Practice Address - Phone:605-360-8918
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-13
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCTB-2022-0199101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health