Healthcare Provider Details

I. General information

NPI: 1457984593
Provider Name (Legal Business Name): CHELSEA CARRE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/18/2020
Last Update Date: 02/06/2024
Certification Date: 02/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 W WILLIAMS ST UNIT 346
APEX NC
27502-1998
US

IV. Provider business mailing address

207 TRACKERS RD
CARY NC
27513-4846
US

V. Phone/Fax

Practice location:
  • Phone: 919-448-6018
  • Fax:
Mailing address:
  • Phone: 919-744-4846
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number15816
License Number StateNC

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: