Chanberlain, Connie Irene

Chanberlain, Connie Irene is an individual health care provider with primary practice located at 145 Morris Rd , Circleville OH 43113-1363. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Marriage & Family Therapist. Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. Chanberlain, Connie Irene can be contacted via phone (740) 474-8874.

Contact Information

Primary practice address
145 Morris Rd Circleville OH 43113-1363
Phone: (740) 474-8874
Fax: (740) 477-1463
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X I9800 Ohio
Behavioral Health & Social Service Providers / Clinical 1041C0700X I9800 Ohio
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X I9800 Ohio

Profile Details

NPI number 1336298579
LBN Legal business name Chanberlain, Connie Irene
Credentials MSW,LISW
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 9th, 2007
Last updated Jul 8th, 2007 - about 19 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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Identifiers

StateTypeNumberIssuer
All States NPI 1336298579 NPPES
Ohio Other 11575147 CAQH
Ohio Other 319962 CAQH

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