Provider Demographics
NPI:1841564978
Name:CHAMBERLAIN, DEREK JOSEPH (LCMHC)
Entity Type:Individual
Prefix:
First Name:DEREK
Middle Name:JOSEPH
Last Name:CHAMBERLAIN
Suffix:
Gender:M
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2780 S JONES BLVD STE 115D
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146-5625
Mailing Address - Country:US
Mailing Address - Phone:702-935-0025
Mailing Address - Fax:702-935-0008
Practice Address - Street 1:2920 N GREEN VALLEY PKWY STE 312
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89014-0412
Practice Address - Country:US
Practice Address - Phone:702-935-0025
Practice Address - Fax:702-935-0008
Is Sole Proprietor?:No
Enumeration Date:2012-03-07
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1169101YM0800X
NVCP0162101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health