Provider Demographics
NPI:1295548477
Name:KIANI, CHELSEA (LMSW)
Entity type:Individual
Prefix:
First Name:CHELSEA
Middle Name:
Last Name:KIANI
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:CHELSEA
Other - Middle Name:
Other - Last Name:KIANI-DEHKIANI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1002 MCCLAIN RD STE 108
Mailing Address - Street 2:
Mailing Address - City:BENTONVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72712-6739
Mailing Address - Country:US
Mailing Address - Phone:479-268-4598
Mailing Address - Fax:
Practice Address - Street 1:1002 MCCLAIN RD STE 108
Practice Address - Street 2:
Practice Address - City:BENTONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72712-6739
Practice Address - Country:US
Practice Address - Phone:479-268-4598
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-30
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR8251-M101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty