Provider Demographics
NPI:1811055783
Name:CHIAPPETTA, MARY HELEN (LCSW)
Entity type:Individual
Prefix:MS
First Name:MARY
Middle Name:HELEN
Last Name:CHIAPPETTA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:MARY
Other - Middle Name:H
Other - Last Name:KORBEL-CHIAPPETTA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:1970 LARKIN AVE
Mailing Address - Street 2:SUITE 9
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60123-5891
Mailing Address - Country:US
Mailing Address - Phone:847-695-7512
Mailing Address - Fax:847-695-1009
Practice Address - Street 1:1970 LARKIN AVE
Practice Address - Street 2:SUITE 9
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60123-5891
Practice Address - Country:US
Practice Address - Phone:847-695-7512
Practice Address - Fax:847-695-1009
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical