Provider Demographics
NPI:1750818324
Name:BARR, CHELSEA BRIELLE (MA)
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:BRIELLE
Last Name:BARR
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1682 SW CULVER HWY
Mailing Address - Street 2:
Mailing Address - City:MADRAS
Mailing Address - State:OR
Mailing Address - Zip Code:97741-9397
Mailing Address - Country:US
Mailing Address - Phone:503-908-4655
Mailing Address - Fax:
Practice Address - Street 1:2622 SW GLACIER PL STE 120-130
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:OR
Practice Address - Zip Code:97756-7623
Practice Address - Country:US
Practice Address - Phone:541-233-9153
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-15
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORR4768106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty