Provider Demographics
NPI:1649855560
Name:RICH, CHANTAL FRANCE (LSW)
Entity type:Individual
Prefix:
First Name:CHANTAL
Middle Name:FRANCE
Last Name:RICH
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:CHANTAL
Other - Middle Name:FRANCE
Other - Last Name:DOUCETTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:602 S WEBSTER AVE
Mailing Address - Street 2:
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18505-4202
Mailing Address - Country:US
Mailing Address - Phone:931-702-5052
Mailing Address - Fax:
Practice Address - Street 1:801 PROSPECT AVE
Practice Address - Street 2:
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18505-1838
Practice Address - Country:US
Practice Address - Phone:570-904-7363
Practice Address - Fax:570-348-4079
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-11
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW135668104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker