Provider Demographics
NPI:1700878808
Name:CHANCELLOR, ANNA LEE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:ANNA
Middle Name:LEE
Last Name:CHANCELLOR
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MISS
Other - First Name:ANNA
Other - Middle Name:LEE
Other - Last Name:BARNHILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:511 E PINE HILL DR
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77351-2464
Mailing Address - Country:US
Mailing Address - Phone:936-933-4391
Mailing Address - Fax:
Practice Address - Street 1:511 E PINE HILL DR
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:TX
Practice Address - Zip Code:77351-2464
Practice Address - Country:US
Practice Address - Phone:936-933-4391
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-16
Last Update Date:2012-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17962101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX154235901Medicaid