Provider Demographics
NPI:1942725924
Name:POUNCY, CHANARA T
Entity type:Individual
Prefix:
First Name:CHANARA
Middle Name:T
Last Name:POUNCY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CHANARA
Other - Middle Name:T
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1608 APPLEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71118-2210
Mailing Address - Country:US
Mailing Address - Phone:318-422-4263
Mailing Address - Fax:
Practice Address - Street 1:1608 APPLEWOOD DR
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71118-2210
Practice Address - Country:US
Practice Address - Phone:318-422-4263
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health