MEDICARE: CHELSEA POWELL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	PY1102	NV

General Provider Information

NPI Number	:	1134940406
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHELSEA POWELL

Provider Business Mailing Address
First Line	:	3766 BATTIPAGLIA AVE
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89044-1905
Country	:	US
Telephone Number	:	269-313-1928
Fax Number	:

Provider Business Practice Location Address
First Line	:	5572 S FORT APACHE RD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89148-3604
Country	:	US
Telephone Number	:	702-503-5592
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/21/2024
Last Update Date	:	10/21/2024

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Directions to “ CHELSEA POWELL ” Practice Location

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