Provider Demographics
NPI:1750771051
Name:CHILCOTE, DAVID LAWRENCE II (MSW)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:LAWRENCE
Last Name:CHILCOTE
Suffix:II
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:795 MYRTLE TER
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34103-2814
Mailing Address - Country:US
Mailing Address - Phone:239-269-8361
Mailing Address - Fax:509-561-1246
Practice Address - Street 1:795 MYRTLE TER
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34103-2814
Practice Address - Country:US
Practice Address - Phone:239-269-8361
Practice Address - Fax:509-561-1246
Is Sole Proprietor?:No
Enumeration Date:2015-01-26
Last Update Date:2015-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34000620A104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker