Provider Demographics
NPI:1417660770
Name:CHATELIER, LEMY
Entity Type:Individual
Prefix:
First Name:LEMY
Middle Name:
Last Name:CHATELIER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2348 JEFFCOTT ST
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33901-5212
Mailing Address - Country:US
Mailing Address - Phone:239-791-6872
Mailing Address - Fax:
Practice Address - Street 1:9410 CORKSCREW PALMS CIR STE 202
Practice Address - Street 2:
Practice Address - City:ESTERO
Practice Address - State:FL
Practice Address - Zip Code:33928-6425
Practice Address - Country:US
Practice Address - Phone:239-595-3022
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-03
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH22961101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty