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General NPI Number Information
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NPI Number | 1780772772
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Entity Type | Individual
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Provider Name | ELIZABETH LANE CHANDLER M.S., Q.M.H.P.
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Gender | Female
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Dates
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Enumeration Date | 10/11/2006
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Last Update Date | 08/20/2009
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Provider Practice Location Address
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Address Line | 622 S 57TH PL
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City | SPRINGFIELD
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State | OR
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Zip | 97478-5487
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Country | US
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Telephone | 541-726-8076
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Fax |
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Provider Business Mailing Address
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Address Line | 2411 MARTIN LUTHER KING BLVD LANE COUNTY BEHAVIORAL HEALTH SERVICES
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City | EUGENE
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State | OR
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Zip | 97401
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Country | US
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Telephone | 541-484-1456
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Fax | 541-682-3276
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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 |
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License Number State |
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