Provider Demographics
NPI:1962504332
Name:CHADDHA, SMITA (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:SMITA
Middle Name:
Last Name:CHADDHA
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:442 KING ST
Mailing Address - Street 2:P.O. BOX 44
Mailing Address - City:LITTLETON
Mailing Address - State:MA
Mailing Address - Zip Code:01460-0044
Mailing Address - Country:US
Mailing Address - Phone:978-808-7269
Mailing Address - Fax:978-264-3910
Practice Address - Street 1:442 KING ST
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:MA
Practice Address - Zip Code:01460-0044
Practice Address - Country:US
Practice Address - Phone:978-808-7269
Practice Address - Fax:978-264-3910
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-05
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3829101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1895401Medicaid