Provider Demographics
NPI:1598328882
Name:CHEGE, ANJANETTE NICOLE ROSE
Entity Type:Individual
Prefix:
First Name:ANJANETTE
Middle Name:NICOLE ROSE
Last Name:CHEGE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:522 GLENLEA LN
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29617-1240
Mailing Address - Country:US
Mailing Address - Phone:864-416-4560
Mailing Address - Fax:
Practice Address - Street 1:522 GLENLEA LN
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29617-1240
Practice Address - Country:US
Practice Address - Phone:864-416-4560
Practice Address - Fax:966-204-1733
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-22
Last Update Date:2019-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC105261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical