Provider Demographics
NPI:1891075065
Name:CHATHAM, JAMES ROBERT II (LPC MHSP)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:ROBERT
Last Name:CHATHAM
Suffix:II
Gender:M
Credentials:LPC MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:256 SEABOARD LN
Mailing Address - Street 2:E-102
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-2875
Mailing Address - Country:US
Mailing Address - Phone:615-812-2640
Mailing Address - Fax:
Practice Address - Street 1:1017 RIDGLEA DR
Practice Address - Street 2:
Practice Address - City:BURNS
Practice Address - State:TN
Practice Address - Zip Code:37029-5255
Practice Address - Country:US
Practice Address - Phone:615-812-2640
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-19
Last Update Date:2011-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLPC0000002721101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional