Provider Demographics
NPI:1730816984
Name:CHANEY, FADENIA (CADC-I)
Entity type:Individual
Prefix:
First Name:FADENIA
Middle Name:
Last Name:CHANEY
Suffix:
Gender:F
Credentials:CADC-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7995 BLUE DIAMOND RD STE 102-397
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89178-9301
Mailing Address - Country:US
Mailing Address - Phone:702-748-0759
Mailing Address - Fax:
Practice Address - Street 1:2465 E TWAIN AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-4011
Practice Address - Country:US
Practice Address - Phone:702-874-3798
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-05
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV07132-I101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)