Healthcare Provider Details

I. General information

NPI: 1952019325
Provider Name (Legal Business Name): CHANING JAMES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2022
Last Update Date: 02/14/2025
Certification Date: 02/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1211 W VINE ST
OPELOUSAS LA
70570-3337
US

IV. Provider business mailing address

1211 W VINE ST
OPELOUSAS LA
70570-3337
US

V. Phone/Fax

Practice location:
  • Phone: 337-678-3201
  • Fax: 337-678-3203
Mailing address:
  • Phone: 337-678-3201
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number17382
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: