Provider Demographics
NPI:1780736082
Name:CHAMBREAU, WILLIAM W III (LMSW AND LPCC)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:W
Last Name:CHAMBREAU
Suffix:III
Gender:M
Credentials:LMSW AND LPCC
Other - Prefix:
Other - First Name:WILLIAM
Other - Middle Name:W
Other - Last Name:CHAMBREAU MA LMSW
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1803 LOUISIANA BLVD NE
Mailing Address - Street 2:SUITE E-2
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-6900
Mailing Address - Country:US
Mailing Address - Phone:505-266-5959
Mailing Address - Fax:505-286-1027
Practice Address - Street 1:1803 LOUISIANA BLVD NE
Practice Address - Street 2:SUITE E-2
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-6900
Practice Address - Country:US
Practice Address - Phone:505-266-5959
Practice Address - Fax:505-286-1027
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-17
Last Update Date:2009-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0208101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM18835830Medicaid