Provider Demographics
NPI:1003624966
Name:JAUBERT, CHELSEA R (MS IN MFT)
Entity type:Individual
Prefix:
First Name:CHELSEA
Middle Name:R
Last Name:JAUBERT
Suffix:
Gender:F
Credentials:MS IN MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 16243
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76162-0243
Mailing Address - Country:US
Mailing Address - Phone:817-773-8326
Mailing Address - Fax:
Practice Address - Street 1:4404 STEPPING STONE DR
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76123-1868
Practice Address - Country:US
Practice Address - Phone:817-773-8326
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-24
Last Update Date:2024-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX205800106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist