Provider Demographics
NPI:1215657879
Name:CHANCY, ADAM (LCSW)
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:
Last Name:CHANCY
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 PRESIDENT GEORGE BUSH HWY APT 6202
Mailing Address - Street 2:
Mailing Address - City:ROWLETT
Mailing Address - State:TX
Mailing Address - Zip Code:75088-1897
Mailing Address - Country:US
Mailing Address - Phone:972-795-1574
Mailing Address - Fax:
Practice Address - Street 1:1600 PRESIDENT GEORGE BUSH HWY APT 6202
Practice Address - Street 2:
Practice Address - City:ROWLETT
Practice Address - State:TX
Practice Address - Zip Code:75088-1897
Practice Address - Country:US
Practice Address - Phone:972-795-1574
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-01
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX601961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical