Provider Demographics
NPI:1003017930
Name:CHAFFIN, ALEISHA BOODOIAN (LPC)
Entity Type:Individual
Prefix:
First Name:ALEISHA
Middle Name:BOODOIAN
Last Name:CHAFFIN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 BOB WALLACE AVENUE
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-6444
Mailing Address - Country:US
Mailing Address - Phone:256-808-2522
Mailing Address - Fax:256-808-2523
Practice Address - Street 1:212 BOB WALLACE AVENUE
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-6444
Practice Address - Country:US
Practice Address - Phone:256-808-2522
Practice Address - Fax:256-808-2523
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-29
Last Update Date:2021-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3050101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor