Chasity Yvette Chambliss, THERAPIST

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH11769 Issued in FL

Practice address

100 Emancipation Dr
Hampton, VA 23667-2829

Phone

(757) 772-9961

NPI assigned

Jan 12, 2011

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in FL, DC, VA3 enrollments

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 3

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Cultivating Mental Wellness

  • Mental Health Counselor
  • Riverview, FL
  • NPI 1700609625

  VA

  Medicare reassignment Authorized official
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  DC

  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1294790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711065600000",
    "number": "1033414743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 POST OAK RD",
            "city": "YORKTOWN",
            "state": "VA",
            "postal_code": "236934967",
            "telephone_number": "727-504-7198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 EMANCIPATION DR",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236672829",
            "telephone_number": "757-772-9961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAMBLISS",
        "first_name": "CHASITY",
        "middle_name": "YVETTE",
        "credential": "THERAPIST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-01-12",
        "last_updated": "2024-03-22",
        "certification_date": "2024-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": "0701012345",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH11769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Certified Home Care Agency LLC
• Dianne E Cesvette, RN
• Roxanne Chalifoux, OD
• Emily Chambers, RD
• Fiona Clare Chambers, DDS
• Shavon Champagne
• Tamika Champagne, FNP
• Yu Kwan Chan, MD
• Emily F Chandler
• Changing Faces Youth Services, LLC

• Mental Health Counselor in Hampton, VA
• Providers in Hampton, VA by specialty
• Mental Health Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.