Chacon, Chastidy Mariah

Chacon, Chastidy Mariah is an individual health care provider with primary practice located at 322 Walnut Street , La Jara CO 81140. She recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as her primary health care specialty. Chacon, Chastidy Mariah can be contacted via phone (719) 587-2288.

Contact Information

Primary practice address
322 Walnut Street La Jara CO 81140
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 18539 Colorado

Profile Details

NPI number 1508581612
LBN Legal business name Chacon, Chastidy Mariah
Credentials Licensed Professional Counselor (LPC)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 11th, 2022
Last updated Oct 24th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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