Healthcare Provider Details

I. General information

NPI: 1932673241
Provider Name (Legal Business Name): CHELSEA LEIGH DANKERT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/20/2019
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1210 RUCKER BLVD
ENTERPRISE AL
36330-3625
US

IV. Provider business mailing address

1210 RUCKER BLVD
ENTERPRISE AL
36330-3625
US

V. Phone/Fax

Practice location:
  • Phone: 260-234-8198
  • Fax: 334-366-3627
Mailing address:
  • Phone: 260-234-8198
  • Fax: 334-366-3627

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC05698
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: