Provider Demographics
NPI:1972020576
Name:PINGSTON, CHELSEA ANN (LLMSW)
Entity Type:Individual
Prefix:MS
First Name:CHELSEA
Middle Name:ANN
Last Name:PINGSTON
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5340 PLYMOUTH RD STE 104
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48105-9557
Mailing Address - Country:US
Mailing Address - Phone:734-335-4747
Mailing Address - Fax:
Practice Address - Street 1:5340 PLYMOUTH RD STE 104
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48105-9557
Practice Address - Country:US
Practice Address - Phone:734-335-4747
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-24
Last Update Date:2021-02-21
Deactivation Date:2020-01-27
Deactivation Code:
Reactivation Date:2021-01-26
Provider Licenses
StateLicense IDTaxonomies
MI247200000X
247200000X
MI6801106365104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other