Basic Information
| Provider Information | |||||||||
| NPI: | 1982811576 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CHAVES | ||||||||
| FirstName: | SUMMER | ||||||||
| MiddleName: | R | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10711 HILLROSE AVE | ||||||||
| Address2: | |||||||||
| City: | BATON ROUGE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 708107736 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2256657878 | ||||||||
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| Practice Location | |||||||||
| Address1: | 30826 LINDER RD | ||||||||
| Address2: | |||||||||
| City: | DENHAM SPRINGS | ||||||||
| State: | LA | ||||||||
| PostalCode: | 707268507 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2256657878 | ||||||||
| FaxNumber: | 2256657856 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/16/2007 | ||||||||
| LastUpdateDate: | 01/14/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | 3315 | LA | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.