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General NPI Number Information
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NPI Number | 1265818769
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Entity Type | Individual
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Provider Name | CYNTHIA LEE CHAUSSE ED.D., L.M.H.C LPC
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Gender | Female
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Dates
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Enumeration Date | 08/06/2015
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Last Update Date | 02/22/2022
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Provider Practice Location Address
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Address Line | 106 N MAIN ST
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City | GALAX
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State | VA
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Zip | 24333-2978
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Country | US
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Telephone | 941-815-0950
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Fax |
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Provider Business Mailing Address
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Address Line | 22 GILMER LN SOUL CARE SOLUTION
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City | GALAX
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State | VA
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Zip | 24333-5173
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Country | US
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Telephone | 941-815-0950
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 070100785
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 070100785
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | MH3566
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 101YS0200X
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Taxonomy Name | School Counselor
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License Number |
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License Number State | FL
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Taxonomy #5
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH3566
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License Number State | FL
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