Individual
MRS. ELLEN E CHESNUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN LMFT INDIANA
Contact information
Practice address
1050 RIBAUT RD, COASTAL EMPIRE COMMUNITY MENTAL HEALTH CENTER, BEAUFORT, SC 29902-5400
(843) 524-8899
(843) 524-8179
Mailing address
1050 RIBAUT RD, COASTAL EMPIRE COMMUNITY MENTAL HEALTH CENTER, BEAUFORT, SC 29902-5400
(843) 524-8899
(843) 524-8179
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
35000689A
IN
163WP0808X
Psychiatric/Mental Health Registered Nurse
28050102A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
474537
VALUE OPTIONS PIN
IN
Enumeration date
04/19/2007
Last updated
03/24/2008
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