Provider Demographics
NPI:1932663002
Name:TOWNSEND, CHANEL ALLEISE (LCSW)
Entity Type:Individual
Prefix:
First Name:CHANEL
Middle Name:ALLEISE
Last Name:TOWNSEND
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4041 KNIGHT ARNOLD RD STE 100
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38118-2128
Mailing Address - Country:US
Mailing Address - Phone:901-572-1573
Mailing Address - Fax:
Practice Address - Street 1:4041 KNIGHT ARNOLD RD STE 100
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38118-2128
Practice Address - Country:US
Practice Address - Phone:901-572-1573
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-23
Last Update Date:2021-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN75111041C0700X
TNLSW0000010683104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker