Provider Demographics
NPI:1043525769
Name:CHAMBERS, MICHELLE LEIGH (MSW LCSW)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:LEIGH
Last Name:CHAMBERS
Suffix:
Gender:F
Credentials:MSW LCSW
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 12423
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27709-2423
Mailing Address - Country:US
Mailing Address - Phone:919-740-2909
Mailing Address - Fax:
Practice Address - Street 1:3403 SKYBROOK LN
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27703-5988
Practice Address - Country:US
Practice Address - Phone:919-740-2909
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-18
Last Update Date:2010-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC006922101YM0800X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical