Healthcare Provider Details

I. General information

NPI: 1851621221
Provider Name (Legal Business Name): JUDITH H CHICK LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/07/2010
Last Update Date: 12/29/2025
Certification Date: 12/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 NICOLS WAY
EASTHAMPTON MA
01027-4405
US

IV. Provider business mailing address

12 NICOLS WAY
EASTHAMPTON MA
01027-4405
US

V. Phone/Fax

Practice location:
  • Phone: 401-477-2664
  • Fax: 401-348-5035
Mailing address:
  • Phone: 401-348-5035
  • Fax: 401-348-5035

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberISW00865
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: