Provider Demographics
NPI:1689287088
Name:WINNERS, CHELSEA CLARE
Entity type:Individual
Prefix:
First Name:CHELSEA
Middle Name:CLARE
Last Name:WINNERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10842 88TH AVE
Mailing Address - Street 2:
Mailing Address - City:SEMINOLE
Mailing Address - State:FL
Mailing Address - Zip Code:33772-3747
Mailing Address - Country:US
Mailing Address - Phone:219-455-7950
Mailing Address - Fax:
Practice Address - Street 1:10842 88TH AVE
Practice Address - Street 2:
Practice Address - City:SEMINOLE
Practice Address - State:FL
Practice Address - Zip Code:33772-3747
Practice Address - Country:US
Practice Address - Phone:219-455-7950
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-25
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-23-65883103K00000X
FLRBT-20-132464106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst