Provider Demographics
NPI:1710949300
Name:CHILCOAT, AMY LB (LCSW)
Entity Type:Individual
Prefix:MS
First Name:AMY
Middle Name:LB
Last Name:CHILCOAT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:39 FIELDSTONE DR
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08876-1710
Mailing Address - Country:US
Mailing Address - Phone:732-398-0400
Mailing Address - Fax:732-422-2485
Practice Address - Street 1:2186 ROUTE 27
Practice Address - Street 2:SUITE 2A
Practice Address - City:NORTH BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08902-1137
Practice Address - Country:US
Practice Address - Phone:732-398-0400
Practice Address - Fax:732-422-2485
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC052396001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical