Provider Demographics
NPI:1891393013
Name:MONROE, CHELSEA LAINE
Entity Type:Individual
Prefix:MRS
First Name:CHELSEA
Middle Name:LAINE
Last Name:MONROE
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 1:809 19TH ST
Mailing Address - Street 2:
Mailing Address - City:MIDDLESBORO
Mailing Address - State:KY
Mailing Address - Zip Code:40965-7759
Mailing Address - Country:US
Mailing Address - Phone:606-248-3042
Mailing Address - Fax:606-248-3060
Practice Address - Street 1:809 19TH ST
Practice Address - Street 2:
Practice Address - City:MIDDLESBORO
Practice Address - State:KY
Practice Address - Zip Code:40965-7759
Practice Address - Country:US
Practice Address - Phone:606-248-3042
Practice Address - Fax:606-248-3060
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-09
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2568341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical