Provider Demographics
NPI:1134953672
Name:DOAN, CHAUNCY CHRISTIAN (LPC)
Entity type:Individual
Prefix:
First Name:CHAUNCY
Middle Name:CHRISTIAN
Last Name:DOAN
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:158 MAGNOLIA LN APT A
Mailing Address - Street 2:
Mailing Address - City:RURAL RETREAT
Mailing Address - State:VA
Mailing Address - Zip Code:24368-6091
Mailing Address - Country:US
Mailing Address - Phone:276-613-7731
Mailing Address - Fax:
Practice Address - Street 1:210 CALHOUN ST
Practice Address - Street 2:
Practice Address - City:GALAX
Practice Address - State:VA
Practice Address - Zip Code:24333-3806
Practice Address - Country:US
Practice Address - Phone:276-601-2749
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-28
Last Update Date:2024-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701013906101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health