Provider Demographics
NPI:1447432257
Name:CHIN, JAMIE LEE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:JAMIE
Middle Name:LEE
Last Name:CHIN
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 1:26 GAS LIGHT DR
Mailing Address - Street 2:APT #9
Mailing Address - City:SOUTH WEYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02190-2219
Mailing Address - Country:US
Mailing Address - Phone:781-803-2099
Mailing Address - Fax:
Practice Address - Street 1:18 NEWTON ST
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02301-5115
Practice Address - Country:US
Practice Address - Phone:508-583-6498
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-04
Last Update Date:2007-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2147211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical