Provider Demographics
NPI:1407106255
Name:CHAMBERS, KERRI L
Entity Type:Individual
Prefix:
First Name:KERRI
Middle Name:L
Last Name:CHAMBERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 CHESHIRE LN
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-2553
Mailing Address - Country:US
Mailing Address - Phone:610-597-9020
Mailing Address - Fax:
Practice Address - Street 1:900A S MAIN ST STE 103
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-5473
Practice Address - Country:US
Practice Address - Phone:410-688-7416
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-19
Last Update Date:2021-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health