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NPI Code Detail

MEDICARE: MS. CHELSIE N. GIAMBRONE LCSW, LISW-S, LICDC

MEDICARE: MS. CHELSIE N. GIAMBRONE LCSW, LISW-S, LICDC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) CounselorICDC.131175OH
21041C0700XClinical Social WorkerI.1302991OH
31041C0700XClinical Social WorkerLCSW70538CA

General Provider Information

NPI Number : 1861812703
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. CHELSIE N. GIAMBRONE LCSW, LISW-S, LICDC
Provider Business Mailing Address
First Line : 4510 EXECUTIVE DR.
Second Line : SUITE 315
City : SAN DIEGO
State : CA
Zip : 92121
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4510 EXECUTIVE DR STE 315
Second Line :
City : SAN DIEGO
State : CA
Zip : 92121-3029
Country : US
Telephone Number : 858-534-8019
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/18/2014
Last Update Date : 07/20/2017

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