MEDICARE: CHELSEY MARIE HOWITZ CO61482100

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	CO61482100	WA

General Provider Information

NPI Number	:	1356113443
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHELSEY MARIE HOWITZ CO61482100

Provider Business Mailing Address
First Line	:	4909 108TH ST SW
Second Line	:
City	:	LAKEWOOD
State	:	WA
Zip	:	98499-3724
Country	:	US
Telephone Number	:	253-276-0042
Fax Number	:

Provider Business Practice Location Address
First Line	:	3214 50TH STREET CT STE D-305
Second Line	:
City	:	GIG HARBOR
State	:	WA
Zip	:	98335-8589
Country	:	US
Telephone Number	:	253-544-4772
Fax Number	:

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

Provider Enumeration Date	:	10/23/2023
Last Update Date	:	10/23/2023

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