MEDICARE: LELA CHAFFIN CSW

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	104100000X	Social Worker	257159	KY

General Provider Information

NPI Number	:	1699461640
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LELA CHAFFIN CSW

Provider Business Mailing Address
First Line	:	496 SOUTHLAND DR
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40503-1827
Country	:	US
Telephone Number	:	859-288-2392
Fax Number	:	859-288-7510

Provider Business Practice Location Address
First Line	:	218 MANDALAY RD
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40504-1333
Country	:	US
Telephone Number	:	859-288-2425
Fax Number	:	859-721-2572

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

Provider Enumeration Date	:	04/13/2023
Last Update Date	:	04/17/2023

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Directions to “ LELA CHAFFIN CSW” Practice Location

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