Provider Demographics
NPI:1245042035
Name:CHIATELLO, ALEXANDRA (LSW)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:
Last Name:CHIATELLO
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:213 W SOUTH ST
Mailing Address - Street 2:
Mailing Address - City:MT STERLING
Mailing Address - State:IL
Mailing Address - Zip Code:62353-1433
Mailing Address - Country:US
Mailing Address - Phone:217-779-4483
Mailing Address - Fax:
Practice Address - Street 1:127 S LIBERTY ST
Practice Address - Street 2:
Practice Address - City:RUSHVILLE
Practice Address - State:IL
Practice Address - Zip Code:62681-1419
Practice Address - Country:US
Practice Address - Phone:217-322-4373
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-21
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150.115906104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker