Provider Demographics
NPI:1740558667
Name:CHAMBERS, KRISTAL CLAYTON (LPC)
Entity Type:Individual
Prefix:MRS
First Name:KRISTAL
Middle Name:CLAYTON
Last Name:CHAMBERS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8921 MANSFIELD RD
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71118-2144
Mailing Address - Country:US
Mailing Address - Phone:318-626-7143
Mailing Address - Fax:
Practice Address - Street 1:8921 MANSFIELD RD
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71118-2144
Practice Address - Country:US
Practice Address - Phone:318-626-7143
Practice Address - Fax:318-626-7143
Is Sole Proprietor?:No
Enumeration Date:2011-12-06
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA4174101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional