Healthcare Provider Details

I. General information

NPI: 1730433079
Provider Name (Legal Business Name): SCARLET CHANCEY LPC, CADCII, ACS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/08/2012
Last Update Date: 07/18/2026
Certification Date: 07/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

345 W MEMORIAL DR
HINESVILLE GA
31313-2413
US

IV. Provider business mailing address

PO BOX 757
GUYTON GA
31312-0757
US

V. Phone/Fax

Practice location:
  • Phone: 912-456-2010
  • Fax: 912-456-2011
Mailing address:
  • Phone: 912-712-1280
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC012915
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCADCII1364
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: