Chandler & Associates | |
1900 Dunbarton Dr Ste J Jackson MS 39216-5015 | |
(769) 428-1681 | |
(769) 241-5091 |
Full Name | Chandler & Associates |
---|---|
Speciality | Counselor |
Location | 1900 Dunbarton Dr Ste J, Jackson, Mississippi |
Authorized Official Name and Position | Tl Chandler (CEO) |
Authorized Official Contact | 7694281681 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Chandler & Associates 1900 Dunbarton Dr Ste J Jackson MS 39216-5015 Ph: (769) 428-1681 | Chandler & Associates 1900 Dunbarton Dr Ste J Jackson MS 39216-5015 Ph: (769) 428-1681 |
NPI Number | 1003447657 |
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Provider Enumeration Date | 02/03/2020 |
Last Update Date | 02/15/2023 |
Certification Date | 02/15/2023 |
Medicare PECOS PAC ID | 5294133377 |
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Medicare Enrollment ID | O20230224002471 |
Identifier | Type | State | Issuer |
---|---|---|---|
1003447657 | NPI | - | NPPES |
06305302 | Medicaid | MS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
Provider Name | Maxie Lerone Gordon |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1427018613 PECOS PAC ID: 2466406798 Enrollment ID: I20050309000456 |
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