Basic Information
| Provider Information | |||||||||
| NPI: | 1619251188 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HEALY | ||||||||
| FirstName: | CHELSIE | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1453 DANA AVE | ||||||||
| Address2: | |||||||||
| City: | SHERIDAN | ||||||||
| State: | WY | ||||||||
| PostalCode: | 828012405 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3074610494 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1898 FORT RD | ||||||||
| Address2: | |||||||||
| City: | SHERIDAN | ||||||||
| State: | WY | ||||||||
| PostalCode: | 828018320 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3076723473 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/03/2011 | ||||||||
| LastUpdateDate: | 06/19/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/19/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | PCSW-476 | WY | N | Behavioral Health & Social Service Providers | Social Worker | Clinical | 1041C0700X | LCSW-899 | WY | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.