Healthcare Provider Details

I. General information

NPI: 1356406763
Provider Name (Legal Business Name): CHASTITY ANN INGRAM LSCSW, LCSW, LMHP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CHASTITY ANN HARMAN LSCSW

II. Dates (important events)

Enumeration Date: 12/26/2006
Last Update Date: 02/06/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

775 31 RD
FRANKLIN NE
68939-5158
US

IV. Provider business mailing address

775 31 RD
FRANKLIN NE
68939-5158
US

V. Phone/Fax

Practice location:
  • Phone: 308-470-1338
  • Fax:
Mailing address:
  • Phone: 308-470-1338
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLSCSW 2494
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number1342
License Number StateNE
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number803
License Number StateNE
# 4
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number3628
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: