MEDICARE: CHELSEA STROUSE CDCA

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	150680	OH

General Provider Information

NPI Number	:	1275997454
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHELSEA STROUSE CDCA

Provider Business Mailing Address
First Line	:	28 PARK AVE W
Second Line	:
City	:	MANSFIELD
State	:	OH
Zip	:	44902-1648
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	28 PARK AVE W
Second Line	:	4TH FLOOR
City	:	MANSFIELD
State	:	OH
Zip	:	44902-1648
Country	:	US
Telephone Number	:	419-522-5015
Fax Number	:

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

Provider Enumeration Date	:	04/13/2016
Last Update Date	:	04/13/2016

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Directions to “ CHELSEA STROUSE CDCA” Practice Location

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