Provider Demographics
NPI:1235400029
Name:KUBS, CHANTE M (LCSW)
Entity Type:Individual
Prefix:
First Name:CHANTE
Middle Name:M
Last Name:KUBS
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 1:6 HIGHVIEW TER
Mailing Address - Street 2:
Mailing Address - City:WHARTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07885-2905
Mailing Address - Country:US
Mailing Address - Phone:201-602-3175
Mailing Address - Fax:
Practice Address - Street 1:6 HIGHVIEW TER
Practice Address - Street 2:
Practice Address - City:WHARTON
Practice Address - State:NJ
Practice Address - Zip Code:07885-2905
Practice Address - Country:US
Practice Address - Phone:201-602-3175
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-25
Last Update Date:2012-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC053980001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical