Provider Demographics
NPI:1801079165
Name:WHITE, CHELSIE KAY (MS LPC)
Entity type:Individual
Prefix:MRS
First Name:CHELSIE
Middle Name:KAY
Last Name:WHITE
Suffix:
Gender:F
Credentials:MS LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 NW KINGS BLVD
Mailing Address - Street 2:
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97330-3900
Mailing Address - Country:US
Mailing Address - Phone:541-757-2400
Mailing Address - Fax:
Practice Address - Street 1:2400 NW KINGS BLVD
Practice Address - Street 2:
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97330-3900
Practice Address - Country:US
Practice Address - Phone:541-757-2400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-10
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORR7209101YM0800X
ORC7777101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health