Healthcare Provider Details

I. General information

NPI: 1114848769
Provider Name (Legal Business Name): MRS. SUMMER MARTIN CHANDLER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

839 W MAIN ST
CENTRE AL
35960-1235
US

IV. Provider business mailing address

317 3RD AVE
PIEDMONT AL
36272-1611
US

V. Phone/Fax

Practice location:
  • Phone: 256-927-5920
  • Fax:
Mailing address:
  • Phone: 256-927-5920
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberALC06051
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: