Provider Demographics
NPI:1508527706
Name:ELLSWORTH, CHASIDY JO (MS, NCC, LPC)
Entity type:Individual
Prefix:MS
First Name:CHASIDY
Middle Name:JO
Last Name:ELLSWORTH
Suffix:
Gender:F
Credentials:MS, NCC, LPC
Other - Prefix:MISS
Other - First Name:CHASIDY
Other - Middle Name:JO
Other - Last Name:PRESTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, NCC
Mailing Address - Street 1:315 MORGANTOWN ST STE 7000
Mailing Address - Street 2:
Mailing Address - City:UNIONTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15401-4878
Mailing Address - Country:US
Mailing Address - Phone:724-557-6598
Mailing Address - Fax:724-550-4160
Practice Address - Street 1:315 MORGANTOWN ST STE 7000
Practice Address - Street 2:
Practice Address - City:UNIONTOWN
Practice Address - State:PA
Practice Address - Zip Code:15401-4878
Practice Address - Country:US
Practice Address - Phone:245-576-5987
Practice Address - Fax:724-550-4160
Is Sole Proprietor?:No
Enumeration Date:2022-01-10
Last Update Date:2024-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)