Provider Demographics
NPI:1689947186
Name:GRANGER, DEANNA CHAPMAN (LPC-S)
Entity type:Individual
Prefix:MRS
First Name:DEANNA
Middle Name:CHAPMAN
Last Name:GRANGER
Suffix:
Gender:F
Credentials:LPC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 TYWOOD CT
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70461-4233
Mailing Address - Country:US
Mailing Address - Phone:504-236-4358
Mailing Address - Fax:
Practice Address - Street 1:104 TYWOOD CT
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70461-4233
Practice Address - Country:US
Practice Address - Phone:504-236-4358
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-14
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS2743101YP2500X
MDLC12061101YP2500X
GA007824101YP2500X
LA6501101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA3147332AMedicaid
GA3147332BMedicaid