Provider Demographics
NPI:1295419463
Name:CHANDLER, MONICA D (LICSW)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:D
Last Name:CHANDLER
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 SPRUCE DR
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:AL
Mailing Address - Zip Code:35570-6925
Mailing Address - Country:US
Mailing Address - Phone:662-962-4491
Mailing Address - Fax:
Practice Address - Street 1:175 SPRUCE DR
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:AL
Practice Address - Zip Code:35570-6925
Practice Address - Country:US
Practice Address - Phone:662-962-4491
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-09
Last Update Date:2023-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL5324C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical