Provider Demographics
NPI:1821507203
Name:EASTON, CHELSEA
Entity type:Individual
Prefix:
First Name:CHELSEA
Middle Name:
Last Name:EASTON
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:CHELSEA
Other - Middle Name:
Other - Last Name:ACTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:14 PINE ST
Mailing Address - Street 2:
Mailing Address - City:KIEFER
Mailing Address - State:OK
Mailing Address - Zip Code:74041-3019
Mailing Address - Country:US
Mailing Address - Phone:918-361-2630
Mailing Address - Fax:
Practice Address - Street 1:14 PINE ST
Practice Address - Street 2:
Practice Address - City:KIEFER
Practice Address - State:OK
Practice Address - Zip Code:74041-3019
Practice Address - Country:US
Practice Address - Phone:918-361-2630
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-28
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK12485101YM0800X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator