Provider Demographics
NPI:1598100919
Name:CHAGNON, JOSEPH (LMHC)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:CHAGNON
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:94 JOHN POTTER RD
Mailing Address - Street 2:
Mailing Address - City:WEST GREENWICH
Mailing Address - State:RI
Mailing Address - Zip Code:02817-2099
Mailing Address - Country:US
Mailing Address - Phone:401-397-8473
Mailing Address - Fax:401-397-9051
Practice Address - Street 1:94 JOHN POTTER RD
Practice Address - Street 2:
Practice Address - City:WEST GREENWICH
Practice Address - State:RI
Practice Address - Zip Code:02817-2099
Practice Address - Country:US
Practice Address - Phone:401-397-8473
Practice Address - Fax:401-397-9051
Is Sole Proprietor?:No
Enumeration Date:2013-04-30
Last Update Date:2013-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIGH57134Medicaid