Healthcare Provider Details

I. General information

NPI: 1669180410
Provider Name (Legal Business Name): CHELSEA REPIC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/10/2022
Last Update Date: 10/06/2025
Certification Date: 10/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 UNION AVE
PITTSBURGH PA
15212-5523
US

IV. Provider business mailing address

2813 N 10TH ST
TAMPA FL
33605-2514
US

V. Phone/Fax

Practice location:
  • Phone: 724-650-3692
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC014300
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH26325
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: