Individual
MS. CHAUNCEY DIOR MORTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
2250 THUNDERSTICK DR STE 1104, LEXINGTON, KY 40505-9009
(859) 254-1035
Mailing address
2250 THUNDERSTICK DR STE 1104, LEXINGTON, KY 40505-9009
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
Primary
252951
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100729010
—
KY
Enumeration date
08/22/2017
Last updated
04/08/2021
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