Provider Demographics
NPI:1023476348
Name:STANTON, CHELSEA (MSW)
Entity type:Individual
Prefix:
First Name:CHELSEA
Middle Name:
Last Name:STANTON
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3131 N COUNTRY CLUB RD
Mailing Address - Street 2:STE 100
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85716-1649
Mailing Address - Country:US
Mailing Address - Phone:520-325-9498
Mailing Address - Fax:520-325-9542
Practice Address - Street 1:3131 N COUNTRY CLUB RD
Practice Address - Street 2:STE 101
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85716-1649
Practice Address - Country:US
Practice Address - Phone:520-325-9498
Practice Address - Fax:520-325-9542
Is Sole Proprietor?:No
Enumeration Date:2016-02-01
Last Update Date:2016-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW-159301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZLCSW-15930OtherSTATE OF ARIZONA BOARD OF BEHAVIORAL HEALTH EXAMINERS