Provider Demographics
NPI:1205111648
Name:CHESKI, KATHLEEN MOORE (LCSW)
Entity type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:MOORE
Last Name:CHESKI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 DONNA DR
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07013-3601
Mailing Address - Country:US
Mailing Address - Phone:862-232-4098
Mailing Address - Fax:
Practice Address - Street 1:155 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:NUTLEY
Practice Address - State:NJ
Practice Address - Zip Code:07110-2311
Practice Address - Country:US
Practice Address - Phone:973-667-1884
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-17
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC052042001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical