Provider Demographics
NPI:1578103560
Name:LETTIE, CHELSEA M (LPCC)
Entity type:Individual
Prefix:
First Name:CHELSEA
Middle Name:M
Last Name:LETTIE
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:CHELSEA
Other - Middle Name:M
Other - Last Name:KOTELES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPCC
Mailing Address - Street 1:5209 DETROIT AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44102-2224
Mailing Address - Country:US
Mailing Address - Phone:216-325-9404
Mailing Address - Fax:
Practice Address - Street 1:5209 DETROIT AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44102-2224
Practice Address - Country:US
Practice Address - Phone:216-325-9355
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-08
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
OHE.2404811101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor