Provider Demographics
NPI:1861215956
Name:CHAMBERS, RODNEY BRYCE (MED, LPC, AADC)
Entity type:Individual
Prefix:
First Name:RODNEY
Middle Name:BRYCE
Last Name:CHAMBERS
Suffix:
Gender:M
Credentials:MED, LPC, AADC
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 555
Mailing Address - Street 2:
Mailing Address - City:DELBARTON
Mailing Address - State:WV
Mailing Address - Zip Code:25670-0555
Mailing Address - Country:US
Mailing Address - Phone:606-625-0626
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 555
Practice Address - Street 2:
Practice Address - City:DELBARTON
Practice Address - State:WV
Practice Address - Zip Code:25670-0555
Practice Address - Country:US
Practice Address - Phone:606-625-0626
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-06
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV3022101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional