Provider Demographics
NPI:1518460641
Name:DEXTER, CHYLAE M (LMSW)
Entity Type:Individual
Prefix:
First Name:CHYLAE
Middle Name:M
Last Name:DEXTER
Suffix:
Gender:F
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:PO BOX 2171
Mailing Address - Street 2:
Mailing Address - City:SACATON
Mailing Address - State:AZ
Mailing Address - Zip Code:85147-0056
Mailing Address - Country:US
Mailing Address - Phone:520-562-3323
Mailing Address - Fax:
Practice Address - Street 1:291 W CASA BLANCA RD.
Practice Address - Street 2:
Practice Address - City:SACATON
Practice Address - State:AZ
Practice Address - Zip Code:85147-0056
Practice Address - Country:US
Practice Address - Phone:520-562-3323
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-15
Last Update Date:2018-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLMSW-131521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical