MEDICARE: ADRIENNE NICOLE CHAMBERS

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
1	101YP2500X	Professional Counselor	PLC9371	LA
2	101Y00000X	Counselor	PLC9371	LA
3	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1134628118
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADRIENNE NICOLE CHAMBERS

Provider Business Mailing Address
First Line	:	42367 DELUXE PLZ
Second Line	:
City	:	HAMMOND
State	:	LA
Zip	:	70403-1243
Country	:	US
Telephone Number	:	985-265-2161
Fax Number	:

Provider Business Practice Location Address
First Line	:	1000 CHINABERRY DR STE 900
Second Line	:
City	:	BOSSIER CITY
State	:	LA
Zip	:	71111-2455
Country	:	US
Telephone Number	:	318-459-6795
Fax Number	:	318-626-5429

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/06/2018
Last Update Date	:	01/15/2026

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