Provider Demographics
NPI:1992295687
Name:MAHLER, CHELSEY
Entity type:Individual
Prefix:
First Name:CHELSEY
Middle Name:
Last Name:MAHLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6520 POE AVENUE
Mailing Address - Street 2:SUITE #200
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45414
Mailing Address - Country:US
Mailing Address - Phone:937-276-3356
Mailing Address - Fax:937-276-9514
Practice Address - Street 1:6520 POE AVENUE
Practice Address - Street 2:SUITE #200
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45414
Practice Address - Country:US
Practice Address - Phone:937-276-3356
Practice Address - Fax:937-276-9514
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-17
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHP.07959103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical