Provider Demographics
NPI:1184761256
Name:WHITE-ELEY, CHANTAY P (LCSW)
Entity type:Individual
Prefix:DR
First Name:CHANTAY
Middle Name:P
Last Name:WHITE-ELEY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:CHANTAY
Other - Middle Name:P
Other - Last Name:WHITE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:316 LISMORE DR
Mailing Address - Street 2:
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20744-6512
Mailing Address - Country:US
Mailing Address - Phone:253-576-8514
Mailing Address - Fax:240-846-5999
Practice Address - Street 1:2121 EISENHOWER AVE STE 301
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22314-4688
Practice Address - Country:US
Practice Address - Phone:253-576-8514
Practice Address - Fax:240-846-5999
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEQ100008421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical