Healthcare Provider Details

I. General information

NPI: 1366799645
Provider Name (Legal Business Name): CHELSEA LYNN SPENCER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/06/2012
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4842 HORSE GULCH LOOP
COLORADO SPRINGS CO
80924-4523
US

IV. Provider business mailing address

4842 HORSE GULCH LOOP
COLORADO SPRINGS CO
80924-4523
US

V. Phone/Fax

Practice location:
  • Phone: 719-508-2480
  • Fax:
Mailing address:
  • Phone: 719-508-2480
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number9917
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number089.0093990
License Number StateVT
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberMSCSW.00000049
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: