Provider Demographics
NPI:1083730204
Name:CHASKY, MICHELLE (LCMHC)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:CHASKY
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 W CANAL ST
Mailing Address - Street 2:APT. 25
Mailing Address - City:WINOOSKI
Mailing Address - State:VT
Mailing Address - Zip Code:05404-2153
Mailing Address - Country:US
Mailing Address - Phone:802-233-0586
Mailing Address - Fax:
Practice Address - Street 1:177 PEARL ST
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05401-3704
Practice Address - Country:US
Practice Address - Phone:802-862-5396
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
VT068-0000701101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health