Individual ProviderCarol Jean ChaseCounselorBehavioral Health & Social Service ProvidersPractice Address601 Wall St, Valparaiso, IN 46383-2512(219) 476-4572PECOS EnrollmentBased on the most recent information from CMS, provider Carol Jean Chase does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records today at 11:05 AM.Profile DetailsProvider ID1881038206Provider TypeIndividualFull NameChase, Carol JeanTitleMissCredentialM.A., LMHCGenderFemaleSole ProprietorYesEnumeration Date4/29/2013Last Updated8/21/2015Contact InformationPractice LocationPractice Address601 Wall St, Valparaiso, IN 46383-2512Phone(219) 476-4572Fax(219) 462-3975Mailing LocationMailing Address601 Wall St, Valparaiso, IN 46383-2512Phone(219) 476-4572Fax(219) 462-3975Provider TaxonomiesCodeDescriptionLicenseCode101YM0800XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicense39002742AIndianaCode101YA0400XDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseUnlisted IssuerCode251S00000XDescriptionCommunity/Behavioral HealthAgenciesLicenseUnlisted Issuer