Individual
DR. CHANCEY FORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, RPT, NCC, NCSC
Contact information
Practice address
105 EXECUTIVE DR STE A, MADISON, MS 39110-8496
(601) 340-9498
(601) 287-6647
Mailing address
272 CALHOUN STATION PKWY STE C, GLUCKSTADT, MS 39110-5541
(662) 739-3505
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2996
MS
101YP2500X
Professional Counselor
2996
MS
Other
Enumeration date
06/22/2023
Last updated
10/01/2025
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