Provider Demographics
NPI:1962932848
Name:GLADE, CHELSEA (LMHC)
Entity type:Individual
Prefix:
First Name:CHELSEA
Middle Name:
Last Name:GLADE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11650 OLIO RD STE 1000-102
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46037-7619
Mailing Address - Country:US
Mailing Address - Phone:317-855-8250
Mailing Address - Fax:
Practice Address - Street 1:11650 OLIO RD STE 1000-102
Practice Address - Street 2:
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46037-7619
Practice Address - Country:US
Practice Address - Phone:317-855-8250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-14
Last Update Date:2022-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39003060A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health