Basic Information
| Provider Information | |||||||||
| NPI: | 1902492895 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ENNIS | ||||||||
| FirstName: | CHELSEA | ||||||||
| MiddleName: | RHIANON | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | PH.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2227 BRAINARD ST APT B | ||||||||
| Address2: | |||||||||
| City: | NEW ORLEANS | ||||||||
| State: | LA | ||||||||
| PostalCode: | 701131503 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9018321577 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2400 CANAL ST | ||||||||
| Address2: | |||||||||
| City: | NEW ORLEANS | ||||||||
| State: | LA | ||||||||
| PostalCode: | 701196535 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5045072000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/15/2020 | ||||||||
| LastUpdateDate: | 12/15/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 12/15/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TC0700X | 1543 | LA | Y | Behavioral Health & Social Service Providers | Psychologist | Clinical |
No ID Information.