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NPI Code Detail

MEDICARE: MRS. MICHELLE LYNN CHACHKES LCSW

MEDICARE: MRS. MICHELLE LYNN CHACHKES LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorCOO3626NC
21041C0700XClinical Social WorkerC003623NC

General Provider Information

NPI Number : 1750574844
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MICHELLE LYNN CHACHKES LCSW
Provider Business Mailing Address
First Line : 10130 PERIMETER PKWY STE 200
Second Line :
City : CHARLOTTE
State : NC
Zip : 28216-0197
Country : US
Telephone Number : 888-849-7379
Fax Number : 855-857-7333
Provider Business Practice Location Address
First Line : 10130 PERIMETER PKWY STE 200
Second Line :
City : CHARLOTTE
State : NC
Zip : 28216-0197
Country : US
Telephone Number : 888-849-7379
Fax Number : 855-857-7333
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/22/2007
Last Update Date : 12/08/2017

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