Provider Demographics
NPI:1033470109
Name:CHANEY, CARMEN L
Entity Type:Individual
Prefix:
First Name:CARMEN
Middle Name:L
Last Name:CHANEY
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 1:210 GATEWAY MALL
Mailing Address - Street 2:SUITE 326
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68505-2489
Mailing Address - Country:US
Mailing Address - Phone:402-261-9273
Mailing Address - Fax:
Practice Address - Street 1:210 GATEWAY MALL
Practice Address - Street 2:SUITE 326
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68505-2489
Practice Address - Country:US
Practice Address - Phone:402-261-9273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-05
Last Update Date:2012-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional