Provider Demographics
NPI:1508832494
Name:CHANEY, H. DAVID (LPC)
Entity Type:Individual
Prefix:
First Name:H. DAVID
Middle Name:
Last Name:CHANEY
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:906 ALLEN AVE
Mailing Address - Street 2:
Mailing Address - City:COOKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38501-2626
Mailing Address - Country:US
Mailing Address - Phone:931-349-0609
Mailing Address - Fax:931-303-0744
Practice Address - Street 1:906 ALLEN AVE
Practice Address - Street 2:
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38501-2626
Practice Address - Country:US
Practice Address - Phone:931-349-0609
Practice Address - Fax:931-303-0744
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-28
Last Update Date:2017-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLPC 1833101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN5441171Medicaid
TN3376955Medicare ID - Type UnspecifiedGROUP NUMBER