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Individual

MISS CAROL JEAN CHASE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.A., LMHC

Contact information

Practice address
601 WALL ST, VALPARAISO, IN 46383-2512
(219) 476-4572
(219) 462-3975
Mailing address
601 WALL ST, VALPARAISO, IN 46383-2512
(219) 476-4572
(219) 462-3975

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
101YM0800X
Mental Health Counselor
Primary
39002742A
IN
251S00000X
Community/Behavioral Health Agency

Other

Enumeration date
04/29/2013
Last updated
08/21/2015
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