Provider Demographics
NPI:1750864401
Name:CHANDLER BEHAVIORAL HEALTH INC.
Entity Type:Organization
Organization Name:CHANDLER BEHAVIORAL HEALTH INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHERRICE
Authorized Official - Middle Name:NICHOLE
Authorized Official - Last Name:CHANDLER
Authorized Official - Suffix:
Authorized Official - Credentials:BA , QMHP-A/C
Authorized Official - Phone:757-969-7066
Mailing Address - Street 1:651 25TH ST APT 407
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23607-4543
Mailing Address - Country:US
Mailing Address - Phone:757-969-7066
Mailing Address - Fax:
Practice Address - Street 1:1731 WALL STREET
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23224-2322
Practice Address - Country:US
Practice Address - Phone:757-969-7066
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-10
Last Update Date:2018-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health