Bridget Renee Chandler

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

A17538 Issued in NC

Practice address

351 Wagoner Dr Ste 175
Fayetteville, NC 28303-4860

Phone

(919) 790-8580

NPI assigned

Jul 21, 2022

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

Enrolled in NC

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.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2020

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  NC

  Medicare reassignment
• Pinnacle Family Services of North Carolina LLC

  • Community/Behavioral Health Agency
  • Fayetteville, NC
  • NPI 1780055368

  Mental Health

  NPD (past)

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

{
    "created_epoch": "1658361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1609501782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "371 NASH RD",
            "city": "SAINT PAULS",
            "state": "NC",
            "postal_code": "283848431",
            "telephone_number": "910-551-0720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "351 WAGONER DR STE 175",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283034860",
            "telephone_number": "919-790-8580"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "351 Wagoner Dr Ste 175",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "NC",
            "postal_code": "283034860",
            "country_code": "US",
            "telephone_number": "919-790-8580",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHANDLER",
        "first_name": "BRIDGET",
        "middle_name": "RENEE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-21",
        "last_updated": "2022-07-21",
        "certification_date": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "A17538",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shamunta K Chambliss
• Victoria Chan
• Renea Michelle Chance, CPT
• Michelle Lynn Chancey
• Ashley Garland Chandler, PT
• Mark S Chandler, M.D.
• Dinesh Narasimhaiah Chandra, M.D.
• Naomi S Chang, LAT, LMBT
• Changing Lives Home Care
• Changing Outcomes, LLC

• Mental Health Counselor in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.