Provider Demographics
NPI:1649977463
Name:BEARD-CHANEY, GERALDINE NEELEY
Entity type:Individual
Prefix:
First Name:GERALDINE
Middle Name:NEELEY
Last Name:BEARD-CHANEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16503 LANCASTER PLACE DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77083-5236
Mailing Address - Country:US
Mailing Address - Phone:832-287-5785
Mailing Address - Fax:
Practice Address - Street 1:16503 LANCASTER PLACE DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77083-5236
Practice Address - Country:US
Practice Address - Phone:832-287-5785
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-13
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX357521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical