Provider Demographics
NPI:1528193851
Name:CHALK, DENISE S (MA, CRC, CCM)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:S
Last Name:CHALK
Suffix:
Gender:F
Credentials:MA, CRC, CCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 FANNING WAY
Mailing Address - Street 2:
Mailing Address - City:PENNINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08534-5133
Mailing Address - Country:US
Mailing Address - Phone:609-882-4772
Mailing Address - Fax:
Practice Address - Street 1:3 FANNING WAY
Practice Address - Street 2:
Practice Address - City:PENNINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08534-5133
Practice Address - Country:US
Practice Address - Phone:609-882-4772
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)