Healthcare Provider Details

I. General information

NPI: 1285198390
Provider Name (Legal Business Name): CHELSEA BUTLER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/23/2019
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2011 MISSOURI AVE APT 2N
SAINT LOUIS MO
63104-2650
US

IV. Provider business mailing address

2011 MISSOURI AVE APT 2N
SAINT LOUIS MO
63104-2650
US

V. Phone/Fax

Practice location:
  • Phone: 618-409-3772
  • Fax:
Mailing address:
  • Phone: 618-409-3772
  • Fax: 314-768-7114

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2021015771
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: