DR. CHANCEY FORT LPC, RPT, NCC, NCSC
NPI 1821774217
Counselor - Mental Health in Madison, MS

Active since June 22, 2023PECOS EnrolledAccepts Medicare Assignment
105 EXECUTIVE DR STE A, MADISON, MS 39110(601) 340-9498(601) 287-6647 Get Directions Write a Review

NPPES record last updated: October 1, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jan 7, 2025, Jun 22, 2023 (2 updates tracked since 2023).

About Dr. Chancey Fort Lpc, Rpt, Ncc, Ncsc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. CHANCEY FORT LPC, RPT, NCC, NCSC (NPI 1821774217) is an individual mental health provider in Madison, Mississippi, licensed in Mississippi (2996) and active in the NPI registry since June 2023. She is enrolled in Medicare PECOS and is a graduate of Other (2014).

NPPES Registry Identity

NPI1821774217
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameDR. CHANCEY FORTCredential: LPC, RPT, NCC, NCSC
Location Address105 EXECUTIVE DR STE AMadison, MS 39110-8496
Mailing Address272 Calhoun Station Pkwy Ste CGluckstadt, MS 39110-5541 · (662) 739-3505
Fax(601) 287-6647
Sole ProprietorYes
Medical School CMSOtherGraduated 2014
Enumeration DateJune 22, 2023
Last NPPES UpdateOctober 1, 20252 updates tracked since enumeration
NPPES CertifiedOctober 1, 2025
NPI 1821774217 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License Licensed in MS · 2996
Also ListedCounselor · ProfessionalTaxonomy 101YP2500X · License 2996 (MS)
105 EXECUTIVE DR STE A, Madison, MS 39110

Other Names 1

Other Name (5)Dr. Chancey Fort Lpc,ncc,ncsc,rpt

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Dr. Chancey Fort Lpc, Rpt, Ncc, Ncsc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID446748453
PECOS Enrollment IDI20251022001248
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Nurse Practitioner (Psychiatric/Mental Health)
105 EXECUTIVE DR STE A
MADISON, MS 39110
Nurse Practitioner (Psychiatric/Mental Health)
105 EXECUTIVE DR STE A
MADISON, MS 39110

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1821774217, enumerated as an "individual" on June 22, 2023.

The provider is located at 105 EXECUTIVE DR STE A MADISON, MS 39110 and the phone number is (601) 340-9498.

Counselor with taxonomy code 101YM0800X and a focus in Mental Health.

The provider might be accepting Accepts: Ambetter from Arkansas Health & Wellness, Ambetter. Please consult your insurance carrier or call the provider to verify.