Provider Demographics
NPI:1013161207
Name:CHICHESTER, MARYJEANNE FRANCIS (MSW, LCSW)
Entity Type:Individual
Prefix:MS
First Name:MARYJEANNE
Middle Name:FRANCIS
Last Name:CHICHESTER
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:35 PORTER AVE
Mailing Address - Street 2:5B
Mailing Address - City:NAUGATUCK
Mailing Address - State:CT
Mailing Address - Zip Code:06770-1973
Mailing Address - Country:US
Mailing Address - Phone:203-759-0341
Mailing Address - Fax:203-723-0702
Practice Address - Street 1:35 PORTER AVE
Practice Address - Street 2:5B
Practice Address - City:NAUGATUCK
Practice Address - State:CT
Practice Address - Zip Code:06770-1973
Practice Address - Country:US
Practice Address - Phone:203-759-0341
Practice Address - Fax:203-723-0702
Is Sole Proprietor?:No
Enumeration Date:2008-11-14
Last Update Date:2015-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0087521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical