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General NPI Number Information
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NPI Number | 1952022469
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Entity Type | Individual
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Provider Name | CHELSEA SHEA MA, LMHC
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Gender | Female
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Dates
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Enumeration Date | 09/05/2022
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Last Update Date | 05/15/2024
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Provider Practice Location Address
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Address Line | 4210 VALLEY RIDGE BLVD STE 138
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City | PONTE VEDRA
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State | FL
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Zip | 32081-5184
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Country | US
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Telephone | 904-560-6198
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Fax |
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Provider Business Mailing Address
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Address Line | 6549 BREVARD ST
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City | SAINT AUGUSTINE
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State | FL
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Zip | 32080-7651
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Country | US
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Telephone | 303-332-4780
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 23753
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License Number State | FL
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