Provider Demographics
NPI:1093864803
Name:CHIMERICAL INC
Entity Type:Organization
Organization Name:CHIMERICAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:MARCH
Authorized Official - Middle Name:
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:ACSW,LMSW,BCD
Authorized Official - Phone:810-733-8500
Mailing Address - Street 1:4511 MILLER RD
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48507-1107
Mailing Address - Country:US
Mailing Address - Phone:810-733-8500
Mailing Address - Fax:810-733-8500
Practice Address - Street 1:4511 MILLER RD
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48507-1107
Practice Address - Country:US
Practice Address - Phone:810-733-8500
Practice Address - Fax:810-733-8500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010184041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1013318OtherCIGNA
MI045048OtherBLUE CARE NETWORK
MI045048OtherMAGELLAN
MI045048OtherVALUE OPTIONS
MI0891601OtherCONNETICUT GENERAL
MI045048OtherBLUE CARE NETWORK
MI1013318OtherCIGNA