Provider Demographics
NPI:1093925067
Name:DEMISCH, CHLOE LYNNE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:CHLOE
Middle Name:LYNNE
Last Name:DEMISCH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 FULTON ST APT 301
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94117-1521
Mailing Address - Country:US
Mailing Address - Phone:415-413-4865
Mailing Address - Fax:
Practice Address - Street 1:870 MARKET ST
Practice Address - Street 2:SUITE 819
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-3099
Practice Address - Country:US
Practice Address - Phone:415-413-4865
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2015-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW618441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical