Provider Demographics
NPI:1891464251
Name:BICKFORD, CHELSEA (FAMILY PEER SUPPORT)
Entity type:Individual
Prefix:
First Name:CHELSEA
Middle Name:
Last Name:BICKFORD
Suffix:
Gender:
Credentials:FAMILY PEER SUPPORT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10427 DETROIT AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44102-1645
Mailing Address - Country:US
Mailing Address - Phone:440-324-1300
Mailing Address - Fax:
Practice Address - Street 1:18151 JEFFERSON PARK RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44130-3496
Practice Address - Country:US
Practice Address - Phone:330-967-0325
Practice Address - Fax:317-520-8200
Is Sole Proprietor?:No
Enumeration Date:2021-09-09
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHFPS.000053175T00000X, 175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist