Healthcare Provider Details

I. General information

NPI: 1831663103
Provider Name (Legal Business Name): PHACIEALEETHAS HEMMINGWAY-CHANDLER LPC, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: PJ CHANDLER

II. Dates (important events)

Enumeration Date: 01/18/2019
Last Update Date: 09/28/2025
Certification Date: 09/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

127 JONESBORO RD # 1065
JONESBORO GA
30236-2468
US

IV. Provider business mailing address

127 JONESBORO RD # 1065
JONESBORO GA
30236-2468
US

V. Phone/Fax

Practice location:
  • Phone: 404-402-9213
  • Fax:
Mailing address:
  • Phone: 404-402-9213
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number010558
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number010558
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: