Provider Demographics
NPI:1518632843
Name:HUNT, DESHALA CHANCHEZ (BS, MSW, LCSW)
Entity Type:Individual
Prefix:MS
First Name:DESHALA
Middle Name:CHANCHEZ
Last Name:HUNT
Suffix:
Gender:F
Credentials:BS, MSW, LCSW
Other - Prefix:
Other - First Name:DESHALA
Other - Middle Name:CHANCHEZ
Other - Last Name:JACKSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BS, MSW, LCSW
Mailing Address - Street 1:1208 OAKCREST GREEN CT
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-6924
Mailing Address - Country:US
Mailing Address - Phone:251-387-8510
Mailing Address - Fax:919-650-1259
Practice Address - Street 1:1208 OAKCREST GREEN CT
Practice Address - Street 2:
Practice Address - City:MORRISVILLE
Practice Address - State:NC
Practice Address - Zip Code:27560-6924
Practice Address - Country:US
Practice Address - Phone:251-387-8510
Practice Address - Fax:919-650-1259
Is Sole Proprietor?:No
Enumeration Date:2021-08-10
Last Update Date:2023-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0160991041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical