Provider Demographics
NPI:1164710109
Name:BEZY, CHRIS ALAN (LCSW)
Entity Type:Individual
Prefix:
First Name:CHRIS
Middle Name:ALAN
Last Name:BEZY
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2179 LIBERTY WAY NW
Mailing Address - Street 2:
Mailing Address - City:CORYDON
Mailing Address - State:IN
Mailing Address - Zip Code:47112
Mailing Address - Country:US
Mailing Address - Phone:812-946-2543
Mailing Address - Fax:
Practice Address - Street 1:2179 LIBERTY WAY NW
Practice Address - Street 2:
Practice Address - City:CORYDON
Practice Address - State:IN
Practice Address - Zip Code:47112
Practice Address - Country:US
Practice Address - Phone:812-946-2543
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-12
Last Update Date:2014-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker