Provider Demographics
NPI:1265430540
Name:CHANDLER, JOAN AUSTIN GRACE (PHD)
Entity type:Individual
Prefix:DR
First Name:JOAN AUSTIN
Middle Name:GRACE
Last Name:CHANDLER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8200 CROWS NEST LN
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27455-9294
Mailing Address - Country:US
Mailing Address - Phone:336-643-5885
Mailing Address - Fax:336-643-6850
Practice Address - Street 1:8200 CROWS NEST LN
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27455-9294
Practice Address - Country:US
Practice Address - Phone:336-643-5885
Practice Address - Fax:336-643-6850
Is Sole Proprietor?:No
Enumeration Date:2005-07-12
Last Update Date:2010-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2113101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6000391Medicaid