Healthcare Provider Details

I. General information

NPI: 1801324728
Provider Name (Legal Business Name): CHELSEA BLUE PARKER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CHELSEA JOHNSON

II. Dates (important events)

Enumeration Date: 05/23/2017
Last Update Date: 04/16/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1422 E 820 N
OREM UT
84097-5481
US

IV. Provider business mailing address

1422 E 820 N
OREM UT
84097-5481
US

V. Phone/Fax

Practice location:
  • Phone: 801-255-5131
  • Fax: 801-255-5131
Mailing address:
  • Phone: 801-255-5131
  • Fax: 801-255-5131

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number13401075-3501
License Number StateUT
# 2
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: