Provider Demographics
NPI:1154813145
Name:CHAFE, HEATHER (MSW)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:CHAFE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 MAMMOTH RD BLDG 1
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03109-4133
Mailing Address - Country:US
Mailing Address - Phone:603-663-8324
Mailing Address - Fax:603-663-8399
Practice Address - Street 1:275 MAMMOTH RD BLDG 1
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03109-4133
Practice Address - Country:US
Practice Address - Phone:603-663-8324
Practice Address - Fax:603-663-8399
Is Sole Proprietor?:No
Enumeration Date:2018-06-05
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical