Healthcare Provider Details

I. General information

NPI: 1689300949
Provider Name (Legal Business Name): CHELSEA SMITH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2022
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

838 CHEMIN DR
BAKER LA
70714-4290
US

IV. Provider business mailing address

838 CHEMIN DR
BAKER LA
70714-4290
US

V. Phone/Fax

Practice location:
  • Phone: 225-360-0625
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: