Provider Demographics
NPI:1295131266
Name:CHANEY COMMUNICATION SERVICES, INC.
Entity type:Organization
Organization Name:CHANEY COMMUNICATION SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MISS
Authorized Official - First Name:JOYCE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:CHANEY
Authorized Official - Suffix:
Authorized Official - Credentials:MED, CCC-SLP
Authorized Official - Phone:404-754-7351
Mailing Address - Street 1:6058 SHADOW LAKE WAY
Mailing Address - Street 2:
Mailing Address - City:LITHONIA
Mailing Address - State:GA
Mailing Address - Zip Code:30058-3160
Mailing Address - Country:US
Mailing Address - Phone:404-754-7351
Mailing Address - Fax:770-413-0507
Practice Address - Street 1:6058 SHADOW LAKE WAY
Practice Address - Street 2:
Practice Address - City:LITHONIA
Practice Address - State:GA
Practice Address - Zip Code:30058-3160
Practice Address - Country:US
Practice Address - Phone:404-754-7351
Practice Address - Fax:770-413-0507
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-18
Last Update Date:2014-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP000983252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000792844EMedicaid