Provider Demographics
NPI:1841543261
Name:CHANCEY, HEATH R (LPC)
Entity type:Individual
Prefix:MR
First Name:HEATH
Middle Name:R
Last Name:CHANCEY
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 SOUTHLAKE PARK
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35244-3608
Mailing Address - Country:US
Mailing Address - Phone:205-987-0724
Mailing Address - Fax:205-987-0725
Practice Address - Street 1:825 RICE MINE ROAD NORTH
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35406-2314
Practice Address - Country:US
Practice Address - Phone:205-764-9844
Practice Address - Fax:205-764-9943
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-23
Last Update Date:2015-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2196101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor