Provider Demographics
NPI:1790399129
Name:RICKERT, CHELSEY KRISTIN
Entity Type:Individual
Prefix:
First Name:CHELSEY
Middle Name:KRISTIN
Last Name:RICKERT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2090 S HANNIBAL WAY APT B
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80013-4024
Mailing Address - Country:US
Mailing Address - Phone:720-336-9926
Mailing Address - Fax:
Practice Address - Street 1:2090 S HANNIBAL WAY APT B
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80013-4024
Practice Address - Country:US
Practice Address - Phone:720-336-9926
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-02
Last Update Date:2020-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health