Provider Demographics
NPI:1144772112
Name:CHANDLER, MONICA LEE (LCSW)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:LEE
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 1:858 WATERLOO DR
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89002-9540
Mailing Address - Country:US
Mailing Address - Phone:801-200-2621
Mailing Address - Fax:702-551-5170
Practice Address - Street 1:858 WATERLOO DR
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89002-9540
Practice Address - Country:US
Practice Address - Phone:801-200-2621
Practice Address - Fax:702-551-5170
Is Sole Proprietor?:No
Enumeration Date:2016-10-26
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV10865-C1041C0700X
225400000X
NV1108P-S104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation PractitionerGroup - Multi-Specialty