Chavis, Dedra Nichele

Chavis, Dedra Nichele is an sole proprietor health care provider with primary practice located at 3024 White Rail Dr , Fuquay Varina NC 27526-3695. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Chavis, Dedra Nichele can be contacted via phone (970) 400-1829.

Contact Information

Primary practice address
3024 White Rail Dr Fuquay Varina NC 27526-3695
Phone: (970) 400-1829
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 21574 North Carolina
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 0015151 Colorado

Profile Details

NPI number 1376048462
LBN Legal business name Chavis, Dedra Nichele
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 29th, 2018
Last updated May 28th, 2026 - about 5 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1376048462 NPPES
Colorado MEDICAID 611458290

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