Provider Demographics
NPI:1912494196
Name:NEEDHAM, CHELSIE ANGLIN (BA, SWT)
Entity Type:Individual
Prefix:
First Name:CHELSIE
Middle Name:ANGLIN
Last Name:NEEDHAM
Suffix:
Gender:F
Credentials:BA, SWT
Other - Prefix:
Other - First Name:CHELSIE
Other - Middle Name:LEANNE
Other - Last Name:ANGLIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:301 OBETZ RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43207-4036
Mailing Address - Country:US
Mailing Address - Phone:614-409-1400
Mailing Address - Fax:
Practice Address - Street 1:600 WAYNE AVE
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45410-1122
Practice Address - Country:US
Practice Address - Phone:614-409-1400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-13
Last Update Date:2018-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.1610380-TRNE104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker