Provider Demographics
NPI:1215318415
Name:BRATCHER, CHANTEL (LPCMH)
Entity type:Individual
Prefix:
First Name:CHANTEL
Middle Name:
Last Name:BRATCHER
Suffix:
Gender:F
Credentials:LPCMH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 PHOENIX AVE
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19702-2406
Mailing Address - Country:US
Mailing Address - Phone:302-480-0116
Mailing Address - Fax:
Practice Address - Street 1:31 PHOENIX AVE
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19702-2406
Practice Address - Country:US
Practice Address - Phone:302-480-0116
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-12
Last Update Date:2015-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEPC0000709101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional