Individual provider Active NPI

Chelsea Tadesse

  • Mental Health Counselor
  • Rockville, MD
National Provider Identifier
1164031381
Registry record updated Mar 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LC13373 Issued in MD
Practice address
9707 Key West Ave Ste 100
Rockville, MD 20850-3992
Phone
(240) 750-6467
NPI assigned
Jul 23, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LC13373 MD Primary

Addresses

Primary practice location

9707 Key West Ave Ste 100
Rockville, MD 20850-3992

Mailing address

8118 Langport Ter
Gaithersburg, MD 20877-1138
Phone (240) 499-4703

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240219002801 MD Practitioner - Mental Health Counselor 8729422696 Reassigns benefits to 1 organization
I20250415000059 DC Practitioner - Mental Health Counselor 8729422696 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Quince Orchard Psychotherapy LLCGroup PAC ID 5395194302, 30 clinicians

Practice addresses (Care Compare)

10 N Jefferson St
Suite 202
Frederick, MD 21701-4865
Phone (240) 750-6467

9707 Key W Ave
Suite 100
Rockville, MD 20850-3992
Phone (240) 750-6467

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Quince Orchard Psychotherapy LLC Mental Health CurrentSince Jan 17, 2024 Accepting new patients
Oasis the Mental Health Center, LLC PastSince Jan 29, 2023 Accepting new patients
Quince Orchard Psychotherapy LLC Mental Health Past Accepting new patients

Locations

1212 E Churchville Rd
Ste 200
Bel Air, MD 21014
Phone (410) 428-0018

10 N Jefferson St
Ste 202
Frederick, MD 21701
Phone (240) 750-6468

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1595462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743379200000",
    "number": "1164031381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8118 LANGPORT TER",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208771138",
            "telephone_number": "240-499-4703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9707 KEY WEST AVE STE 100",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208503992",
            "telephone_number": "240-750-6467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TADESSE",
        "first_name": "CHELSEA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-23",
        "last_updated": "2025-03-31",
        "certification_date": "2025-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "LC13373",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville, MD

Sources for this page

Verify at the official NPI Registry.