Provider Demographics
NPI:1538200340
Name:CHANEY, CARA J (LCSW)
Entity type:Individual
Prefix:MRS
First Name:CARA
Middle Name:J
Last Name:CHANEY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:650 JOEL DRIVE, 4TH FLOOR, RM 4AA06
Mailing Address - Street 2:
Mailing Address - City:FORT CAMPBELL
Mailing Address - State:KY
Mailing Address - Zip Code:42223-5349
Mailing Address - Country:US
Mailing Address - Phone:270-461-0841
Mailing Address - Fax:270-461-0906
Practice Address - Street 1:650 JOEL DRIVE, 4TH FLOOR, 4AA06
Practice Address - Street 2:
Practice Address - City:FORT CAMPBELL
Practice Address - State:KY
Practice Address - Zip Code:42223-5349
Practice Address - Country:US
Practice Address - Phone:270-461-0841
Practice Address - Fax:270-461-0906
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLSW00000051251041C0700X
TN51251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3376955Medicare ID - Type UnspecifiedGROUP NUMBER