Provider Demographics
NPI:1528198900
Name:CHATTERTON, JOAN (LCSW, RN, CADC)
Entity Type:Individual
Prefix:MS
First Name:JOAN
Middle Name:
Last Name:CHATTERTON
Suffix:
Gender:F
Credentials:LCSW, RN, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2110 DUNCAN RD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-4602
Mailing Address - Country:US
Mailing Address - Phone:302-999-1106
Mailing Address - Fax:302-999-1753
Practice Address - Street 1:2110 DUNCAN RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-4602
Practice Address - Country:US
Practice Address - Phone:302-999-1106
Practice Address - Fax:302-999-1753
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE257101YA0400X
DEQ1-00005301041C0700X
DEL1- 0014019163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE5844509OtherAETNA PROVIDER ID #