Healthcare Provider Details

I. General information

NPI: 1689195083
Provider Name (Legal Business Name): CHELSEA TREIBER MA, LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2017
Last Update Date: 07/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4001 OFFICE COURT DR STE 102
SANTA FE NM
87507-4903
US

IV. Provider business mailing address

3834 KSK LN
SANTA FE NM
87507-3355
US

V. Phone/Fax

Practice location:
  • Phone: 505-983-8225
  • Fax:
Mailing address:
  • Phone: 651-442-2268
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberT-0186791
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: