Provider Demographics
NPI:1639328339
Name:HENKEL, CHAYA DEVIN (LMSW)
Entity Type:Individual
Prefix:MS
First Name:CHAYA
Middle Name:DEVIN
Last Name:HENKEL
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:CHAYA
Other - Middle Name:DEVIN
Other - Last Name:GIESZER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:325 E H ST
Mailing Address - Street 2:
Mailing Address - City:IRON MOUNTAIN
Mailing Address - State:MI
Mailing Address - Zip Code:49801-4760
Mailing Address - Country:US
Mailing Address - Phone:906-774-3300
Mailing Address - Fax:
Practice Address - Street 1:787 MARKET ST
Practice Address - Street 2:
Practice Address - City:HANCOCK
Practice Address - State:MI
Practice Address - Zip Code:49930-1163
Practice Address - Country:US
Practice Address - Phone:906-482-7762
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-17
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801090640104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1639328339Medicaid