Provider Demographics
NPI:1205244050
Name:CHIARAMONTI, JENNIFER (MS/EDS LPES NCSP)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:CHIARAMONTI
Suffix:
Gender:F
Credentials:MS/EDS LPES NCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 BEE ST APT 718
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29401-5707
Mailing Address - Country:US
Mailing Address - Phone:631-384-6013
Mailing Address - Fax:
Practice Address - Street 1:7301 RIVERS AVE STE 100
Practice Address - Street 2:
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29406-4650
Practice Address - Country:US
Practice Address - Phone:843-637-4211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-24
Last Update Date:2018-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4609103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool