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NPI Code Detail

MEDICARE: MRS. CONNIE THOMPSON CHAMBERS LCSW

MEDICARE: MRS. CONNIE THOMPSON CHAMBERS LCSW
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
11041C0700XClinical Social Worker34004330AIN

General Provider Information

NPI Number : 1518064781
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CONNIE THOMPSON CHAMBERS LCSW
Provider Business Mailing Address
First Line : 606 E MAIN ST
Second Line :
City : MADISON
State : IN
Zip : 47250-4708
Country : US
Telephone Number : 812-265-4151
Fax Number : 812-265-5028
Provider Business Practice Location Address
First Line : 606 E MAIN ST
Second Line :
City : MADISON
State : IN
Zip : 47250-4708
Country : US
Telephone Number : 812-265-4151
Fax Number : 812-265-5028
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2006
Last Update Date : 07/08/2007

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