Provider Demographics
NPI:1477814184
Name:CHASE, CHERALYNN RENEE (LPC, LPCC)
Entity type:Individual
Prefix:MS
First Name:CHERALYNN
Middle Name:RENEE
Last Name:CHASE
Suffix:
Gender:F
Credentials:LPC, LPCC
Other - Prefix:
Other - First Name:CHERALYNN
Other - Middle Name:RENEE
Other - Last Name:SABANKAYA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC, LPCC
Mailing Address - Street 1:PO BOX 1347
Mailing Address - Street 2:
Mailing Address - City:MOUNT SHASTA
Mailing Address - State:CA
Mailing Address - Zip Code:96067-1347
Mailing Address - Country:US
Mailing Address - Phone:530-471-8703
Mailing Address - Fax:888-231-3855
Practice Address - Street 1:542 WASHINGTON ST STE 201
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OR
Practice Address - Zip Code:97520-1951
Practice Address - Country:US
Practice Address - Phone:530-471-8703
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-30
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA4406101YM0800X
ORC4220101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty