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General NPI Number Information
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NPI Number | 1144430844
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Entity Type | Individual
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Provider Name | CARY L CHAMBERLAIN LCSW
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Gender | Male
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Dates
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Enumeration Date | 05/23/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 750 WEST RIDGEVIEW DRIVE SUITE 103
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City | ST. GEORGE
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State | UT
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Zip | 84770
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Country | US
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Telephone | 435-632-0946
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Fax |
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Provider Business Mailing Address
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Address Line | 138 N 100 E
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City | WASHINGTON
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State | UT
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Zip | 84780-1631
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Country | US
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Telephone | 435-628-6069
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 266736-3501
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License Number State | UT
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