Basic Information
| Provider Information | |||||||||
| NPI: | 1174932859 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TRICE | ||||||||
| FirstName: | CHELSEA | ||||||||
| MiddleName: | MAULDEN | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | LCSW | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | MAULDEN | ||||||||
| OtherFirstName: | CHELSEA | ||||||||
| OtherMiddleName: | |||||||||
| OtherNamePrefix: | |||||||||
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| OtherCredential: | CSW | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 4615 GOVERNMENT ST | ||||||||
| Address2: | BUILDING 2 | ||||||||
| City: | BATON ROUGE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 708065922 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2259254282 | ||||||||
| FaxNumber: | 2259251987 | ||||||||
| Practice Location | |||||||||
| Address1: | 4615 GOVERNMENT ST | ||||||||
| Address2: | BUILDING 1 | ||||||||
| City: | BATON ROUGE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 70806 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2259220445 | ||||||||
| FaxNumber: | 2259222658 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/07/2014 | ||||||||
| LastUpdateDate: | 06/13/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041S0200X | 12793 | LA | Y | Behavioral Health & Social Service Providers | Social Worker | School |
No ID Information.