Provider Demographics
NPI:1083981849
Name:CHANDLER, LEJEUNE (LCSW)
Entity Type:Individual
Prefix:MISS
First Name:LEJEUNE
Middle Name:
Last Name:CHANDLER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6300 OLD CANTON RD
Mailing Address - Street 2:15103
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39211-2441
Mailing Address - Country:US
Mailing Address - Phone:601-842-6666
Mailing Address - Fax:
Practice Address - Street 1:6300 OLD CANTON RD
Practice Address - Street 2:15103
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39211-2441
Practice Address - Country:US
Practice Address - Phone:601-842-6666
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-22
Last Update Date:2011-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSC75641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical