Provider Demographics
NPI:1699216275
Name:CHLEBOWSKI, JOSEPH (LSW)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:CHLEBOWSKI
Suffix:
Gender:M
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4400 ROUTE 9 S
Mailing Address - Street 2:SUITE 1000
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728
Mailing Address - Country:US
Mailing Address - Phone:732-610-4122
Mailing Address - Fax:732-317-4969
Practice Address - Street 1:4400 ROUTE 9 S
Practice Address - Street 2:SUITE 1000
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-1383
Practice Address - Country:US
Practice Address - Phone:732-610-4122
Practice Address - Fax:732-317-4969
Is Sole Proprietor?:No
Enumeration Date:2017-03-15
Last Update Date:2017-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ2015-000477101YA0400X
NJ44SL06208400104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)