Provider Demographics
NPI:1588811186
Name:CHANDLER, JOAN ELIZABETH (LCSW)
Entity type:Individual
Prefix:
First Name:JOAN
Middle Name:ELIZABETH
Last Name:CHANDLER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:JOAN
Other - Middle Name:ELIZABETH
Other - Last Name:CHANDLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW-R
Mailing Address - Street 1:74 GALWAY DR
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14623-5255
Mailing Address - Country:US
Mailing Address - Phone:585-334-0025
Mailing Address - Fax:
Practice Address - Street 1:945 E HENRIETTA RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14623-1419
Practice Address - Country:US
Practice Address - Phone:585-202-0022
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-26
Last Update Date:2012-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY071223101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health