Provider Demographics
NPI:1023077518
Name:CHELST, TAMY S (PHD)
Entity type:Individual
Prefix:DR
First Name:TAMY
Middle Name:S
Last Name:CHELST
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22536 N BELLWOOD DR
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48034-2115
Mailing Address - Country:US
Mailing Address - Phone:800-357-6879
Mailing Address - Fax:248-353-2268
Practice Address - Street 1:22536 N BELLWOOD DR
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48034-2115
Practice Address - Country:US
Practice Address - Phone:800-357-6879
Practice Address - Fax:248-353-2268
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-22
Last Update Date:2009-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA572231H00000X
CT000173237700000X
MI1601000156231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI640003157OtherPALMETTO GBA-RAILROAD
MAAD0043OtherBCBS MA
MA5102839Medicaid
MA711249OtherHARVARD PILGRIM
MA792556OtherTUFTS
MI0F32633OtherHEALTH ALLIANCE PLAN(HAP)
MI1506196OtherUMWA
MI804697126Medicaid
MI87945OtherBLUE CARE NETWORK
MA640002190OtherPALMETTO GBA-RAILROAD
MI640F32633OtherBCBS MI
MI640F32633OtherBCBS MI
MI87945OtherBLUE CARE NETWORK
MA711249OtherHARVARD PILGRIM