Provider Demographics
NPI:1881140457
Name:MCCLUSKEY, CHELSEA CAROLINE
Entity type:Individual
Prefix:
First Name:CHELSEA
Middle Name:CAROLINE
Last Name:MCCLUSKEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10919 72ND RD APT 5F
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-5389
Mailing Address - Country:US
Mailing Address - Phone:201-874-1150
Mailing Address - Fax:
Practice Address - Street 1:10470 QUEENS BLVD FL 2
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-3638
Practice Address - Country:US
Practice Address - Phone:888-272-9355
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-01
Last Update Date:2024-07-09
Deactivation Date:2024-06-27
Deactivation Code:
Reactivation Date:2024-07-09
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker