Doctor Name: | MS. ERICA CHESTNUT |
NPI Number: | 1215124334 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MC, LISAC |
License Number: | LISAC-10600 |
Business Practice Address: | 4425 W Olive Ave 194 Glendale, AZ - 853023843 |
Business Phone Number: | 4802620508 |
Business Fax Number: | 6026291536 |
Mailing Address: | 4425 W Olive Ave, 194 GLENDALE |
State: | AZ |
Postal Code: | 853023843 |
Phone Number: | 4802620508 |
Fax Number: | 6026291536 |
NPI Enumeration Date: | 10/02/2007 |
NPI Last Update Date: | 10/02/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | LISAC-10600 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |