Provider Demographics
NPI:1184961559
Name:CHAMBERLAIN, TOCCARA ANN (LPCA)
Entity type:Individual
Prefix:MS
First Name:TOCCARA
Middle Name:ANN
Last Name:CHAMBERLAIN
Suffix:
Gender:F
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3809 E VANCROFT CIR UNIT C8
Mailing Address - Street 2:
Mailing Address - City:WINTERVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28590-5853
Mailing Address - Country:US
Mailing Address - Phone:252-268-9529
Mailing Address - Fax:
Practice Address - Street 1:3809 E VANCROFT CIR UNIT C8
Practice Address - Street 2:
Practice Address - City:WINTERVILLE
Practice Address - State:NC
Practice Address - Zip Code:28590-5853
Practice Address - Country:US
Practice Address - Phone:252-268-9529
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-05
Last Update Date:2013-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA9832101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional