Provider Demographics
NPI:1265810402
Name:CHANEY, CHRISTINA MARIA (LCSW)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:MARIA
Last Name:CHANEY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:CHRISTINA
Other - Middle Name:
Other - Last Name:RINGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 336
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:KY
Mailing Address - Zip Code:40392-0336
Mailing Address - Country:US
Mailing Address - Phone:859-927-3013
Mailing Address - Fax:859-203-0662
Practice Address - Street 1:120 S MAPLE ST STE 2
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:KY
Practice Address - Zip Code:40391-1928
Practice Address - Country:US
Practice Address - Phone:859-987-5090
Practice Address - Fax:859-987-5006
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-07
Last Update Date:2020-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY37341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100373650Medicaid
KY3734OtherLICENSE