Healthcare Provider Details

I. General information

NPI: 1588023923
Provider Name (Legal Business Name): MICHELLE QUNAI CHAMBERS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2016
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

655 7TH ST
WARNER ROBINS GA
31098-2227
US

IV. Provider business mailing address

655 7TH ST
WARNER ROBINS GA
31098-2227
US

V. Phone/Fax

Practice location:
  • Phone: 478-327-8398
  • Fax:
Mailing address:
  • Phone: 478-327-8398
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC012087
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904013543
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: