Provider Demographics
NPI:1730433079
Name:CHANCEY, SCARLET (LPC, CADCII, ACS)
Entity type:Individual
Prefix:
First Name:SCARLET
Middle Name:
Last Name:CHANCEY
Suffix:
Gender:F
Credentials:LPC, CADCII, ACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 757
Mailing Address - Street 2:
Mailing Address - City:GUYTON
Mailing Address - State:GA
Mailing Address - Zip Code:31312-0757
Mailing Address - Country:US
Mailing Address - Phone:912-977-0529
Mailing Address - Fax:912-500-2970
Practice Address - Street 1:345 W MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:HINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:31313-2413
Practice Address - Country:US
Practice Address - Phone:912-456-2010
Practice Address - Fax:912-456-2011
Is Sole Proprietor?:No
Enumeration Date:2012-11-08
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACADCII1364101YA0400X
GALPC012915101YP2500X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional