Provider Demographics
NPI:1962897579
Name:LEITNER, CHELSEA A (LMHCA, CSAC, ATR, CC)
Entity type:Individual
Prefix:
First Name:CHELSEA
Middle Name:A
Last Name:LEITNER
Suffix:
Gender:F
Credentials:LMHCA, CSAC, ATR, CC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6790 MURRAY AVE SW
Mailing Address - Street 2:#30
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98136-1785
Mailing Address - Country:US
Mailing Address - Phone:808-256-6090
Mailing Address - Fax:
Practice Address - Street 1:6790 MURRAY AVE SW
Practice Address - Street 2:#30
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98136-1785
Practice Address - Country:US
Practice Address - Phone:808-256-6090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-31
Last Update Date:2015-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI111-11101YA0400X
WAMC60517756101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)