Provider Demographics
NPI:1447602768
Name:GARDELLA-POLICH, CHANEL (LCSW)
Entity type:Individual
Prefix:MRS
First Name:CHANEL
Middle Name:
Last Name:GARDELLA-POLICH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:CHANEL
Other - Middle Name:
Other - Last Name:GARDELLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1100 RIDGEFIELD BLVD
Mailing Address - Street 2:SUITE 190
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28806-6209
Mailing Address - Country:US
Mailing Address - Phone:828-670-7723
Mailing Address - Fax:
Practice Address - Street 1:1100 RIDGEFIELD BLVD
Practice Address - Street 2:SUITE 190
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28806-6209
Practice Address - Country:US
Practice Address - Phone:828-670-7723
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-11
Last Update Date:2020-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0116611041C0700X
NCP0106411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical