Provider Demographics
NPI:1831469956
Name:CHANDA CAMDEN, LCSW, P.A.
Entity Type:Organization
Organization Name:CHANDA CAMDEN, LCSW, P.A.
Other - Org Name:CHANDA CAMDEN INTEGRATIVE THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT / OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHANDA
Authorized Official - Middle Name:DANIELLE
Authorized Official - Last Name:CAMDEN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:501-975-0009
Mailing Address - Street 1:401 W CAPITOL AVE
Mailing Address - Street 2:SUITE 301
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72201-3421
Mailing Address - Country:US
Mailing Address - Phone:501-975-0009
Mailing Address - Fax:501-975-0009
Practice Address - Street 1:401 W CAPITOL AVE
Practice Address - Street 2:SUITE 301
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72201-3421
Practice Address - Country:US
Practice Address - Phone:501-975-0009
Practice Address - Fax:501-975-0009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-05
Last Update Date:2012-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2437-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty