1477117299 NPI number — MISS CHELSIE LYNN POWERS CANADIDATE FOR LPC

Table of content: MISS CHELSIE LYNN POWERS CANADIDATE FOR LPC (NPI 1477117299)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477117299 NPI number — MISS CHELSIE LYNN POWERS CANADIDATE FOR LPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
POWERS
Provider First Name:
CHELSIE
Provider Middle Name:
LYNN
Provider Name Prefix Text:
MISS
Provider Name Suffix Text:
Provider Credential Text:
CANADIDATE FOR LPC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
POWERS
Provider Other First Name:
CHELSIE
Provider Other Middle Name:
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
CANADIDATE FOR LPC
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1477117299
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/11/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
618 E 27TH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EDMOND
Provider Business Mailing Address State Name:
OK
Provider Business Mailing Address Postal Code:
73013-5221
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
405-889-9188
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2921 NW 156TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EDMOND
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
73013-2101
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
405-513-7794
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/26/2019

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101Y00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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