Provider Demographics
NPI:1326657214
Name:WINDY, CHANTEL AMELIA-LYN-MARIE (LMSW)
Entity Type:Individual
Prefix:
First Name:CHANTEL
Middle Name:AMELIA-LYN-MARIE
Last Name:WINDY
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5224 W DARBEE RD
Mailing Address - Street 2:
Mailing Address - City:FAIRGROVE
Mailing Address - State:MI
Mailing Address - Zip Code:48733-9764
Mailing Address - Country:US
Mailing Address - Phone:307-220-8372
Mailing Address - Fax:
Practice Address - Street 1:5224 W DARBEE RD
Practice Address - Street 2:
Practice Address - City:FAIRGROVE
Practice Address - State:MI
Practice Address - Zip Code:48733-9764
Practice Address - Country:US
Practice Address - Phone:307-220-8372
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-27
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
MI68011071201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical