Provider Demographics
NPI:1639479660
Name:CHAMBLISS, CURTIS LEE II (MS, LMHC, LPC-MHSP)
Entity Type:Individual
Prefix:MR
First Name:CURTIS
Middle Name:LEE
Last Name:CHAMBLISS
Suffix:II
Gender:M
Credentials:MS, LMHC, LPC-MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9005 OVERLOOK BLVD
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-5269
Mailing Address - Country:US
Mailing Address - Phone:615-236-1100
Mailing Address - Fax:407-641-9508
Practice Address - Street 1:9005 OVERLOOK BLVD
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-5269
Practice Address - Country:US
Practice Address - Phone:615-236-1100
Practice Address - Fax:407-641-9508
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-25
Last Update Date:2023-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLPC6476101YM0800X
FLMH14831101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL014499700Medicaid