Provider Demographics
NPI:1144037250
Name:CHANEY, MACY DAVENPORT (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:MACY
Middle Name:DAVENPORT
Last Name:CHANEY
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:MACY
Other - Middle Name:ERIN
Other - Last Name:DAVENPORT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:1751 SCOTTSVILLE RD STE 9
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42104-3357
Mailing Address - Country:US
Mailing Address - Phone:270-796-6800
Mailing Address - Fax:
Practice Address - Street 1:1751 SCOTTSVILLE RD STE 9
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42104-3357
Practice Address - Country:US
Practice Address - Phone:270-796-6800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-12
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY285171235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist