Provider Demographics
NPI:1477284206
Name:DILLON, CHANTELL SACRAMENTO (LPCT)
Entity Type:Individual
Prefix:DR
First Name:CHANTELL
Middle Name:SACRAMENTO
Last Name:DILLON
Suffix:
Gender:F
Credentials:LPCT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7516 BLUEBONNET BLVD # 159
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70810-1627
Mailing Address - Country:US
Mailing Address - Phone:225-371-3861
Mailing Address - Fax:
Practice Address - Street 1:3940 PRESCOTT RD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70805
Practice Address - Country:US
Practice Address - Phone:225-371-3861
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-22
Last Update Date:2022-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional