Healthcare Provider Details

I. General information

NPI: 1295361749
Provider Name (Legal Business Name): CHAIA GRUBBS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/17/2020
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

357 NEW BRUNSWICK AVE
PERTH AMBOY NJ
08861-3940
US

IV. Provider business mailing address

357 NEW BRUNSWICK AVE
PERTH AMBOY NJ
08861-3940
US

V. Phone/Fax

Practice location:
  • Phone: 732-442-3632
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number20259
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC06303000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: