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NPI Code Detail

MEDICARE: MR. BRETT MICHAEL CHAMBLEY M.A LPC

MEDICARE: MR. BRETT MICHAEL CHAMBLEY M.A LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor5928LA

General Provider Information

NPI Number : 1053743757
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. BRETT MICHAEL CHAMBLEY M.A LPC
Provider Business Mailing Address
First Line : 2802 HODGES ST
Second Line :
City : LAKE CHARLES
State : LA
Zip : 70601-7368
Country : US
Telephone Number : 337-419-1873
Fax Number :
Provider Business Practice Location Address
First Line : 2802 HODGES ST
Second Line :
City : LAKE CHARLES
State : LA
Zip : 70601-7368
Country : US
Telephone Number : 337-419-1873
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/05/2013
Last Update Date : 01/19/2017

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