Basic Information
Provider Information
NPI: 1053745083
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CARNAHAN
FirstName: CHELSEY
MiddleName: ANNA
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 231 LOCUST DR
Address2:  
City: MOON TOWNSHIP
State: PA
PostalCode: 151089709
CountryCode: US
TelephoneNumber: 4126611239
FaxNumber: 4126611304
Practice Location
Address1: 6324 MARCHAND ST
Address2:  
City: PITTSBURGH
State: PA
PostalCode: 152064312
CountryCode: US
TelephoneNumber: 4126611239
FaxNumber: 4126611304
Other Information
ProviderEnumerationDate: 08/27/2013
LastUpdateDate: 08/27/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800X  Y Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


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