Provider Demographics
NPI:1396573044
Name:KIRKPATRICK, CHELSEA (LLPC)
Entity type:Individual
Prefix:
First Name:CHELSEA
Middle Name:
Last Name:KIRKPATRICK
Suffix:
Gender:F
Credentials:LLPC
Other - Prefix:
Other - First Name:CHELSEA
Other - Middle Name:
Other - Last Name:CADY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:602 S SUTTON RD
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49203-2434
Mailing Address - Country:US
Mailing Address - Phone:517-392-7685
Mailing Address - Fax:
Practice Address - Street 1:126 SEYMOUR AVE
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49202-3558
Practice Address - Country:US
Practice Address - Phone:734-219-3314
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-24
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6451023742101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional