| Dairlyn Chelette Lcsw Llc | |
|
4530 S Berkeley Lake Rd Ste B Berkeley Lake GA 30071-1657 | |
| (770) 446-5642 | |
| (770) 446-5643 |
| Full Name | Dairlyn Chelette Lcsw Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 4530 S Berkeley Lake Rd Ste B, Berkeley Lake, Georgia |
| Authorized Official Name and Position | Dairlyn Chelette (OWNER/PROVIDER) |
| Authorized Official Contact | 7704465642 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dairlyn Chelette Lcsw Llc 4530 S Berkeley Lake Rd Ste B Berkeley Lake GA 30071-1657 Ph: (770) 446-5642 | Dairlyn Chelette Lcsw Llc 4530 S Berkeley Lake Rd Ste B Berkeley Lake GA 30071-1657 Ph: (770) 446-5642 |
| NPI Number | 1215592118 |
|---|---|
| Provider Enumeration Date | 05/06/2019 |
| Last Update Date | 05/06/2019 |
| Medicare PECOS PAC ID | 7810224557 |
|---|---|
| Medicare Enrollment ID | O20190803000164 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215592118 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Dairlyn Chelette |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083784417 PECOS PAC ID: 3375713506 Enrollment ID: I20110826000111 |
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