Provider Demographics
NPI:1295525087
Name:WILDER, CHELSEA SUZANNE (MSW, CSW, LCSW)
Entity type:Individual
Prefix:
First Name:CHELSEA
Middle Name:SUZANNE
Last Name:WILDER
Suffix:
Gender:
Credentials:MSW, CSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2299 N YARNALLTON PIKE
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40511-9024
Mailing Address - Country:US
Mailing Address - Phone:859-576-3318
Mailing Address - Fax:
Practice Address - Street 1:824 EUCLID AVE STE A102
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40502-1785
Practice Address - Country:US
Practice Address - Phone:859-365-0184
Practice Address - Fax:859-788-3940
Is Sole Proprietor?:No
Enumeration Date:2025-05-07
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2603211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical