Provider Demographics
NPI:1013666262
Name:NEELY, CHELSEA NICHOLE
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:NICHOLE
Last Name:NEELY
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 1:1950 COYNE ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96826-1331
Mailing Address - Country:US
Mailing Address - Phone:808-321-1633
Mailing Address - Fax:
Practice Address - Street 1:203 KAPAA QUARRY PLAZA
Practice Address - Street 2:#5002
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734
Practice Address - Country:US
Practice Address - Phone:808-741-2232
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-23
Last Update Date:2022-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst