Provider Demographics
NPI:1851691992
Name:TAICO, CHRYSECOLLA (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:CHRYSECOLLA
Middle Name:
Last Name:TAICO
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UNC HOSPITAL
Mailing Address - Street 2:FIRST FLOOR NEUROSCIENCES HOSPITAL CB#7160
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27599-7160
Mailing Address - Country:US
Mailing Address - Phone:919-843-9207
Mailing Address - Fax:
Practice Address - Street 1:UNC HOSPITAL
Practice Address - Street 2:FIRST FLOOR NEUROSCIENCES HOSPITAL CB#7160
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27599-0001
Practice Address - Country:US
Practice Address - Phone:919-843-9207
Practice Address - Fax:919-843-8802
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-22
Last Update Date:2010-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0070211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical