Provider Demographics
NPI:1144531484
Name:CHIT CHAT THERAPY SERVICES, PLLC
Entity type:Organization
Organization Name:CHIT CHAT THERAPY SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHARISSE
Authorized Official - Middle Name:N
Authorized Official - Last Name:GAINEY
Authorized Official - Suffix:
Authorized Official - Credentials:MED, CCC-SLP
Authorized Official - Phone:910-297-4252
Mailing Address - Street 1:PO BOX 48023
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:NC
Mailing Address - Zip Code:28331-8023
Mailing Address - Country:US
Mailing Address - Phone:910-297-4252
Mailing Address - Fax:
Practice Address - Street 1:603 COUNTRY CLUB DR
Practice Address - Street 2:SUITE 2
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28301-7686
Practice Address - Country:US
Practice Address - Phone:910-297-4252
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-01
Last Update Date:2010-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7297235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty