Provider Demographics
NPI:1437411006
Name:JENNINGS, CHELSEA HORROCKS (LCSW-C)
Entity type:Individual
Prefix:MS
First Name:CHELSEA
Middle Name:HORROCKS
Last Name:JENNINGS
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:CHELSEA
Other - Middle Name:LEE
Other - Last Name:HORROCKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:407 CANNON ST
Mailing Address - Street 2:
Mailing Address - City:CHESTERTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21620-1329
Mailing Address - Country:US
Mailing Address - Phone:443-480-4183
Mailing Address - Fax:
Practice Address - Street 1:400 S CROSS ST STE 1B
Practice Address - Street 2:
Practice Address - City:CHESTERTOWN
Practice Address - State:MD
Practice Address - Zip Code:21620-4705
Practice Address - Country:US
Practice Address - Phone:443-924-6297
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-11
Last Update Date:2021-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD190331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD119591300Medicaid
211862Medicare Oscar/Certification
MDS118Medicare PIN