Provider Demographics
NPI:1841380136
Name:CHIZMADIA, JANET R (MA, LPC, LCADC, CHT)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:R
Last Name:CHIZMADIA
Suffix:
Gender:F
Credentials:MA, LPC, LCADC, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 CHERRYHILL RD
Mailing Address - Street 2:
Mailing Address - City:MILLTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08850-1309
Mailing Address - Country:US
Mailing Address - Phone:732-742-2719
Mailing Address - Fax:
Practice Address - Street 1:3 AUER CT STE F
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-5825
Practice Address - Country:US
Practice Address - Phone:732-742-2719
Practice Address - Fax:732-545-9544
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00179300101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional