Provider Demographics
NPI:1457481038
Name:CHENNAT, VASANTHY C (LPCMH)
Entity Type:Individual
Prefix:MS
First Name:VASANTHY
Middle Name:C
Last Name:CHENNAT
Suffix:
Gender:F
Credentials:LPCMH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 N JAMES ST
Mailing Address - Street 2:SUITE 111
Mailing Address - City:NEWPORT
Mailing Address - State:DE
Mailing Address - Zip Code:19804-3169
Mailing Address - Country:US
Mailing Address - Phone:302-407-1645
Mailing Address - Fax:302-295-6289
Practice Address - Street 1:240 N JAMES ST
Practice Address - Street 2:SUITE 111
Practice Address - City:NEWPORT
Practice Address - State:DE
Practice Address - Zip Code:19804-3169
Practice Address - Country:US
Practice Address - Phone:302-407-1645
Practice Address - Fax:302-295-6289
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEPC-0000373101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health