Healthcare Provider Details

I. General information

NPI: 1649709957
Provider Name (Legal Business Name): CHELSEA LEIGH THURMAN MA-CCC SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2017
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 LAKE BEND DR
VALLEY PARK MO
63088-2524
US

IV. Provider business mailing address

3108 WHEELING DR
SAINT CHARLES MO
63301-2473
US

V. Phone/Fax

Practice location:
  • Phone: 636-289-0465
  • Fax:
Mailing address:
  • Phone: 618-530-7320
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number146013533
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number2025035695
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: