Provider Demographics
NPI:1801533716
Name:BARTH, CHELSEA SHIELDS (CSW)
Entity type:Individual
Prefix:
First Name:CHELSEA
Middle Name:SHIELDS
Last Name:BARTH
Suffix:
Gender:F
Credentials:CSW
Other - Prefix:
Other - First Name:CHELSEA
Other - Middle Name:ANNE
Other - Last Name:SHIELDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CSW
Mailing Address - Street 1:10300 BROOKRIDGE VILLAGE BLVD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40291-4474
Mailing Address - Country:US
Mailing Address - Phone:502-785-4322
Mailing Address - Fax:
Practice Address - Street 1:10300 BROOKRIDGE VILLAGE BLVD STE 104
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40291-4474
Practice Address - Country:US
Practice Address - Phone:502-785-4322
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-13
Last Update Date:2022-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY254972104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker