Provider Demographics
NPI:1043337553
Name:CHANEY, JILL N (LPC)
Entity Type:Individual
Prefix:MRS
First Name:JILL
Middle Name:N
Last Name:CHANEY
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 1:125 DONS WAY
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71913-3908
Mailing Address - Country:US
Mailing Address - Phone:501-620-5130
Mailing Address - Fax:501-620-5109
Practice Address - Street 1:125 DONS WAY
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71913
Practice Address - Country:US
Practice Address - Phone:501-624-7111
Practice Address - Fax:501-620-5109
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2010-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP0708046101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR1043337553OtherUNITY MGED MH A/K/A ST JOHN'S MMH
AR1043337553OtherTRICARE
AR2431377OtherCIGNA
AR710401764OtherMHNET
AR07100011100OtherQUAL-CHOICE
AR1043337553OtherNOVASYSTEMS/GMCO
710401764OtherST JOHNS MERCY MBH
710401764OtherMHN
AR1043337553OtherBCBS
AR116399726Medicaid
AR1082913OtherUSA MGED CARE
710401764OtherCORPHEALTH
AR710401764OtherEMPLOYEE HEALTH COALITION