Individual
CHELSEA A PHELAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSS/QMHP-C
Contact information
Practice address
620 NE 2ND ST, GRESHAM, OR 97030
(971) 274-3757
(503) 912-5740
Mailing address
1776 SW MADISON ST, PORTLAND, OR 97205-1715
(971) 386-2278
(503) 224-4494
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
19-QMHPC-00068
OR
175T00000X
Peer Specialist
THW0001422
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500718984
—
OR
05
—
500730515
—
OR
Enumeration date
10/25/2016
Last updated
03/31/2021
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