Healthcare Provider Details

I. General information

NPI: 1518335751
Provider Name (Legal Business Name): CHELSI ANN KLENTZ DAVIS PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/04/2015
Last Update Date: 07/29/2022
Certification Date: 07/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3201 PIONEERS BLVD STE 218
LINCOLN NE
68502-5963
US

IV. Provider business mailing address

3201 PIONEERS BLVD STE 218
LINCOLN NE
68502-5963
US

V. Phone/Fax

Practice location:
  • Phone: 402-235-8181
  • Fax:
Mailing address:
  • Phone: 402-235-8181
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number508
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number908
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: