Provider Demographics
NPI:1003510504
Name:CHANEY, JAMES CHARLES (PLMHP)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:CHARLES
Last Name:CHANEY
Suffix:
Gender:M
Credentials:PLMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14710 W DODGE RD STE 200
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68154-2027
Mailing Address - Country:US
Mailing Address - Phone:402-709-8338
Mailing Address - Fax:
Practice Address - Street 1:14710 W DODGE RD STE 200
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68154-2027
Practice Address - Country:US
Practice Address - Phone:402-709-8338
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-28
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE13286101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health