Provider Demographics
NPI:1851009583
Name:STATLER, CHANEY (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:CHANEY
Middle Name:
Last Name:STATLER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 S STATE ST UNIT 408
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60605-3624
Mailing Address - Country:US
Mailing Address - Phone:415-517-7755
Mailing Address - Fax:
Practice Address - Street 1:1401 S STATE ST UNIT 408
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60605-3624
Practice Address - Country:US
Practice Address - Phone:415-517-7755
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-11
Last Update Date:2022-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA51413101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health