Ellen E Chesnut, RN LMFT INDIANA

Individual provider Active NPI Marriage & Family Therapist · Beaufort, SC

NPI 1043437270 · NPPES record last updated Mar 24, 2008

Key facts

NPI
1043437270
Entity type
Individual (NPI type 1)
Primary specialty
Marriage & Family Therapist 106H00000X
License
35000689A (IN)
Practice address
1050 Ribaut Rd
Coastal Empire Community Mental Health Center
Beaufort, SC 29902-5400
Phone
(843) 524-8899
Fax
(843) 524-8179
NPI assigned
Apr 19, 2007
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Certified Nurse Specialist, Registered Nurse

State licenses

LicenseStateTypeSpecialty
35000689AINMDMarriage & Family Therapist
28050102AINMDPsychiatric/Mental Health Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 35000689A IN Yes
Psychiatric/Mental Health Registered Nurse 163WP0808X 28050102A IN

Addresses

Primary practice location

1050 Ribaut Rd
Coastal Empire Community Mental Health Center
Beaufort, SC 29902-5400

Mailing address

1050 Ribaut Rd
Coastal Empire Community Mental Health Center
Beaufort, SC 29902-5400
Phone (843) 524-8899

Other identifiers

IdentifierTypeStateIssuer
474537OtherINVALUE OPTIONS PIN

Other providers in Beaufort, SC

All providers in Beaufort, SC · Marriage & Family Therapist in South Carolina

Sources for this page

Verify at the official NPI Registry.