Individual
CONNIE IRENE CHANBERLAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW,LISW
Contact information
Practice address
145 MORRIS RD, CIRCLEVILLE, OH 43113-1363
(740) 474-8874
(740) 477-1463
Mailing address
145 MORRIS RD, CIRCLEVILLE, OH 43113-1363
(740) 474-8874
(740) 477-1463
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
I9800
OH
1041C0700X
Clinical Social Worker
I9800
OH
106H00000X
Marriage & Family Therapist
Primary
I9800
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11575147
CAQH
OH
01
—
319962
MHN MANAGED HEALTH NETWOR
OH
Enumeration date
01/09/2007
Last updated
09/11/2025
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