Provider Demographics
NPI:1992255475
Name:FIELDS, CHANTRELL (LPC)
Entity type:Individual
Prefix:MS
First Name:CHANTRELL
Middle Name:
Last Name:FIELDS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:941 W I 35 FRONTAGE RD STE 116
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73034-7375
Mailing Address - Country:US
Mailing Address - Phone:405-747-6065
Mailing Address - Fax:
Practice Address - Street 1:209 HARVEST RD
Practice Address - Street 2:
Practice Address - City:GUTHRIE
Practice Address - State:OK
Practice Address - Zip Code:73044-4431
Practice Address - Country:US
Practice Address - Phone:405-269-7385
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-10
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKJ083576630101Y00000X, 101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor