Individual provider · Type 1 NPI

Channing Renee Lackey

Addiction (Substance Use Disorder) Counselor · Corona, CA

NPI number 1104384635 Active

Practice location

222 W 6th St
Corona, CA 92882-3301

Call (888) 682-6282 Map

Mailing address

13267 Roswell Ave
Chino, CA 91710-4771

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400XNone listed

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1104384635

Channing Renee Lackey's National Provider Identifier is 1104384635, issued on Mar 4, 2019. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Corona, CA. The record was last updated on Aug 27, 2025.