Provider Demographics
NPI:1043911720
Name:CHAMBERLIN, BRANDI (PHD, LPC)
Entity type:Individual
Prefix:
First Name:BRANDI
Middle Name:
Last Name:CHAMBERLIN
Suffix:
Gender:F
Credentials:PHD, LPC
Other - Prefix:
Other - First Name:BRANDI
Other - Middle Name:
Other - Last Name:POWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:110 GRACIE CT
Mailing Address - Street 2:
Mailing Address - City:EVINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:24550-2448
Mailing Address - Country:US
Mailing Address - Phone:434-229-7819
Mailing Address - Fax:
Practice Address - Street 1:20276 TIMBERLAKE RD STE A
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24502-7214
Practice Address - Country:US
Practice Address - Phone:434-319-5528
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-10
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701012275101YP2500X, 101YM0800X, 101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor