Provider Demographics
NPI:1215213673
Name:CHASSIN, BETH ROSE (MSW, LCSW)
Entity Type:Individual
Prefix:MRS
First Name:BETH
Middle Name:ROSE
Last Name:CHASSIN
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9790 VIA AMATI
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33467
Mailing Address - Country:US
Mailing Address - Phone:561-366-7404
Mailing Address - Fax:561-366-7405
Practice Address - Street 1:9790 VIA AMATI
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33467
Practice Address - Country:US
Practice Address - Phone:561-366-7404
Practice Address - Fax:561-366-7405
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-31
Last Update Date:2019-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC052599001041C0700X
FLSW105271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical