Provider Demographics
NPI:1154596476
Name:CHIN, NANCY (LLBSW, CAC-II)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:CHIN
Suffix:
Gender:F
Credentials:LLBSW, CAC-II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6840 MIDLAND RD
Mailing Address - Street 2:
Mailing Address - City:FREELAND
Mailing Address - State:MI
Mailing Address - Zip Code:48623-8708
Mailing Address - Country:US
Mailing Address - Phone:989-692-2160
Mailing Address - Fax:989-692-2165
Practice Address - Street 1:6840 MIDLAND RD.
Practice Address - Street 2:
Practice Address - City:FREELAND
Practice Address - State:MI
Practice Address - Zip Code:48623-2329
Practice Address - Country:US
Practice Address - Phone:989-692-2160
Practice Address - Fax:989-692-2165
Is Sole Proprietor?:No
Enumeration Date:2008-04-28
Last Update Date:2013-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6802085847101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor