Provider Demographics
NPI:1447084876
Name:CHELSEA LEEDS ART THERAPY AND COUNSELING
Entity type:Organization
Organization Name:CHELSEA LEEDS ART THERAPY AND COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:CHELSEA
Authorized Official - Middle Name:
Authorized Official - Last Name:MYRICK
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:317-458-5894
Mailing Address - Street 1:7611 VENETIAN WAY
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46217-4381
Mailing Address - Country:US
Mailing Address - Phone:317-989-5465
Mailing Address - Fax:
Practice Address - Street 1:5226 S EAST ST STE A9
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46227-1982
Practice Address - Country:US
Practice Address - Phone:317-458-5894
Practice Address - Fax:317-981-1652
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-28
Last Update Date:2024-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
14249626OtherCAQH
IN39003261AOtherSTATE COUNSELING LICENSE
1497243653OtherINDIVIDUAL NPI