Healthcare Provider Details

I. General information

NPI: 1942933700
Provider Name (Legal Business Name): JULISSA CHAPARRO LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2022
Last Update Date: 05/25/2026
Certification Date: 05/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3635 BELL BLVD STE 203
BAYSIDE NY
11361-2097
US

IV. Provider business mailing address

2255 STATE ROUTE 32 UNIT 619
MODENA NY
12548-7027
US

V. Phone/Fax

Practice location:
  • Phone: 718-504-9256
  • Fax:
Mailing address:
  • Phone: 845-200-9230
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number118626
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: