Provider Demographics
NPI:1417400102
Name:CHIARIELLO BEHAVIORAL HEALTH
Entity Type:Organization
Organization Name:CHIARIELLO BEHAVIORAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMANTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHIARIELLO
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:708-689-4684
Mailing Address - Street 1:18440 THOMPSON CT
Mailing Address - Street 2:SUITE 207
Mailing Address - City:TINLEY PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60477-5426
Mailing Address - Country:US
Mailing Address - Phone:708-689-4684
Mailing Address - Fax:
Practice Address - Street 1:18440 THOMPSON CT
Practice Address - Street 2:SUITE 207
Practice Address - City:TINLEY PARK
Practice Address - State:IL
Practice Address - Zip Code:60477-5426
Practice Address - Country:US
Practice Address - Phone:708-689-4684
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-28
Last Update Date:2016-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health