Provider Demographics
NPI:1972923324
Name:ALLEN, CHELSEA (LMSW)
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:
Last Name:ALLEN
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 1:206 MEDICINE BOW TRL
Mailing Address - Street 2:
Mailing Address - City:DEL RIO
Mailing Address - State:TX
Mailing Address - Zip Code:78840-2023
Mailing Address - Country:US
Mailing Address - Phone:484-855-9009
Mailing Address - Fax:
Practice Address - Street 1:16350 BLANCO RD
Practice Address - Street 2:SUITE 110B
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-3339
Practice Address - Country:US
Practice Address - Phone:484-855-9009
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-24
Last Update Date:2016-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX61665104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker