Provider Demographics
NPI:1881724581
Name:CHIMIENTI, PATRICIA (LCSW)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:CHIMIENTI
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 1:294 SCHOOLEYS MOUNTAIN RD
Mailing Address - Street 2:POB 141
Mailing Address - City:SCHOOLEYS MOUNTAIN
Mailing Address - State:NJ
Mailing Address - Zip Code:07870
Mailing Address - Country:US
Mailing Address - Phone:908-684-1183
Mailing Address - Fax:908-813-1334
Practice Address - Street 1:294 SCHOOLEYS MOUNTAIN RD
Practice Address - Street 2:POB 141
Practice Address - City:SCHOOLEYS MOUNTAIN
Practice Address - State:NJ
Practice Address - Zip Code:07870
Practice Address - Country:US
Practice Address - Phone:908-684-1183
Practice Address - Fax:908-813-1334
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC05172900101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7215386OtherATENA
NJ265662OtherMHN
NJP2812737OtherOXFORD
NJ7215386OtherATENA