Allen Kenneth Chalk, MS,CAP
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Deland, FL
NPI 1093534836 · NPPES record last updated Oct 8, 2024
Key facts
- NPI
- 1093534836
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- CAP.0100572 (FL)
- Practice address
- 1251 N Stone St
Deland, FL 32720-2584 - Phone
- (386) 623-3361
- NPI assigned
- Oct 8, 2024
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CAP.0100572 | FL | MD | Addiction (Substance Use Disorder) Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | CAP.0100572 | FL | Yes |
Addresses
Primary practice location
1251 N Stone St
Deland, FL 32720-2584
Mailing address
36927 Slice LN
Grand Island, FL 32735-8449
Phone (352) 740-5517
Other providers in Deland, FL
- Central Florida Pathologists Laboratory Inc
- Central Florida Quality Care Services, Inc.
- Central Florida Quality Care Services, Inc.
- Central Florida Regional Hospital, Inc.
- Alexandra Frances Cervantes
- Kathleen Chapin
- Scott Chaput
- Laura C Chase
- Marjorie Cheng
- Edwin Cheung
All providers in Deland, FL · Addiction (Substance Use Disorder) Counselor in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 8, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.