Provider Demographics
NPI:1194530212
Name:GORD, CHELSEA RANA (COUNSELOR INTERN)
Entity type:Individual
Prefix:
First Name:CHELSEA
Middle Name:RANA
Last Name:GORD
Suffix:
Gender:F
Credentials:COUNSELOR INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 BRIAR CT
Mailing Address - Street 2:
Mailing Address - City:MOSCOW MILLS
Mailing Address - State:MO
Mailing Address - Zip Code:63362-2442
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:539 N GRAND BLVD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63103-1026
Practice Address - Country:US
Practice Address - Phone:314-652-3623
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-07
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health