Provider Demographics
NPI:1154195378
Name:CHANDLER, DOLORES (LCSWA)
Entity type:Individual
Prefix:
First Name:DOLORES
Middle Name:
Last Name:CHANDLER
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3608 UNIVERSITY DR STE 101
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-6260
Mailing Address - Country:US
Mailing Address - Phone:919-433-0170
Mailing Address - Fax:919-226-0026
Practice Address - Street 1:3608 UNIVERSITY DR STE 101
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-6260
Practice Address - Country:US
Practice Address - Phone:919-433-0170
Practice Address - Fax:919-226-0026
Is Sole Proprietor?:No
Enumeration Date:2023-11-08
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0196191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical