Individual
MISS KELLY LYNN CHATTERTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
809 N ARTHUR AVE, POCATELLO, ID 83204-2803
(208) 339-4632
Mailing address
5201 COLE ST, CHUBBUCK, ID 83202-4955
(208) 339-4632
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
122928
ID
104100000X
Social Worker
LMSW-9471661
ID
1041C0700X
Clinical Social Worker
Primary
LMSW-9471661
ID
Other
Enumeration date
04/09/2020
Last updated
08/07/2025
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