Chante Pantila, DBH

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LAC-13696 Issued in AZ

Practice address

1209 S 1St Ave
Phoenix, AZ 85003-2605

Phone

(602) 258-6797

Fax

(602) 254-7121

NPI assigned

Oct 14, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1381708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381708800000",
    "number": "1437587201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1209 S 1ST AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850032605",
            "telephone_number": "602-258-6797",
            "fax_number": "602-254-7121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1209 S 1ST AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850032605",
            "telephone_number": "602-258-6797",
            "fax_number": "602-254-7121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANTILA",
        "first_name": "CHANTE",
        "name_prefix": "Dr.",
        "credential": "DBH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-10-14",
        "last_updated": "2013-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AZ",
            "license": "LAC-13696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Mental Health Counselor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2013; 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.