Provider Demographics
NPI:1386789113
Name:CHANCEY, KELLY MORGAN
Entity type:Individual
Prefix:MISS
First Name:KELLY
Middle Name:MORGAN
Last Name:CHANCEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 E DAVIS AVE
Mailing Address - Street 2:OKLAHOMA HALL ROOM 348
Mailing Address - City:WEATHERFORD
Mailing Address - State:OK
Mailing Address - Zip Code:73096-3017
Mailing Address - Country:US
Mailing Address - Phone:816-853-9406
Mailing Address - Fax:
Practice Address - Street 1:104 E DAVIS AVE
Practice Address - Street 2:OKLAHOMA HALL ROOM 348
Practice Address - City:WEATHERFORD
Practice Address - State:OK
Practice Address - Zip Code:73096-3017
Practice Address - Country:US
Practice Address - Phone:816-853-9406
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health