Provider Demographics
NPI:1801357652
Name:MANZON, CHELSEA F (LMSW)
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:F
Last Name:MANZON
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1622 BLUESTONE ST APT I
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:MD
Mailing Address - Zip Code:21076-1805
Mailing Address - Country:US
Mailing Address - Phone:919-381-2462
Mailing Address - Fax:443-200-0267
Practice Address - Street 1:9199 REISTERSTOWN RD STE 104
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-4520
Practice Address - Country:US
Practice Address - Phone:410-552-0773
Practice Address - Fax:443-200-0267
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-26
Last Update Date:2019-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD22834101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health