Provider Demographics
NPI:1225831035
Name:CHAMBERS, CHARLA
Entity type:Individual
Prefix:
First Name:CHARLA
Middle Name:
Last Name:CHAMBERS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9901 DIANA DR
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76542-5595
Mailing Address - Country:US
Mailing Address - Phone:254-952-8511
Mailing Address - Fax:
Practice Address - Street 1:1103 W STAN SCHLUETER LOOP STE 100
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76549-6691
Practice Address - Country:US
Practice Address - Phone:254-952-8511
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-28
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker