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NPI Code Detail

MEDICARE: CHELSEY ENTLER PEER SUPPORT

MEDICARE: CHELSEY ENTLER PEER SUPPORT
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
1175T00000XPeer Specialist007296OH

General Provider Information

NPI Number : 1801755509
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHELSEY ENTLER PEER SUPPORT
Provider Business Mailing Address
First Line : 26 N WESTERN AVE
Second Line :
City : SPRINGFIELD
State : OH
Zip : 45504-2762
Country : US
Telephone Number : 937-925-2615
Fax Number :
Provider Business Practice Location Address
First Line : 4977 NORTHCUTT PL
Second Line :
City : DAYTON
State : OH
Zip : 45414-3839
Country : US
Telephone Number : 800-829-5461
Fax Number : 800-829-5461
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/19/2026
Last Update Date : 01/19/2026

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Directions to “ CHELSEY ENTLER PEER SUPPORT” Practice Location

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