Provider Demographics
NPI:1790939775
Name:CHAMBLEE, NIKKI ANNETTE (LMSW)
Entity Type:Individual
Prefix:MISS
First Name:NIKKI
Middle Name:ANNETTE
Last Name:CHAMBLEE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7102 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:FRESH MEADOWS
Mailing Address - State:NY
Mailing Address - Zip Code:11365-4105
Mailing Address - Country:US
Mailing Address - Phone:347-743-4349
Mailing Address - Fax:718-523-3358
Practice Address - Street 1:7102 PARK AVE
Practice Address - Street 2:
Practice Address - City:FRESH MEADOWS
Practice Address - State:NY
Practice Address - Zip Code:11365-4105
Practice Address - Country:US
Practice Address - Phone:347-743-4349
Practice Address - Fax:718-523-3358
Is Sole Proprietor?:No
Enumeration Date:2008-11-04
Last Update Date:2011-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY068718104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker