Provider Demographics
NPI:1831863745
Name:HERMES, CHELSEA RAE (LCPC)
Entity type:Individual
Prefix:MS
First Name:CHELSEA
Middle Name:RAE
Last Name:HERMES
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 CROWN PT
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62704-1069
Mailing Address - Country:US
Mailing Address - Phone:217-622-2210
Mailing Address - Fax:
Practice Address - Street 1:3000 CROWN PT
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:IL
Practice Address - Zip Code:62704-1069
Practice Address - Country:US
Practice Address - Phone:217-622-2210
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-04
Last Update Date:2021-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.012487101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional