Provider Demographics
NPI:1417529090
Name:CHANES, ABEL (LMSW)
Entity Type:Individual
Prefix:
First Name:ABEL
Middle Name:
Last Name:CHANES
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1774 N SILVER MOUNTAIN PL
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85745-1900
Mailing Address - Country:US
Mailing Address - Phone:520-869-6419
Mailing Address - Fax:
Practice Address - Street 1:1774 N SILVER MOUNTAIN PL
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85745-1900
Practice Address - Country:US
Practice Address - Phone:520-869-6419
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-13
Last Update Date:2021-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLMSW-18076104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker