Healthcare Provider Details

I. General information

NPI: 1528245495
Provider Name (Legal Business Name): JULIE B CHAFFEE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/23/2008
Last Update Date: 11/05/2025
Certification Date: 11/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

777 SUNRISE HWY STE 200
LYNBROOK NY
11563-2950
US

IV. Provider business mailing address

192 BURTIS AVE
ROCKVILLE CENTRE NY
11570-2434
US

V. Phone/Fax

Practice location:
  • Phone: 516-350-8564
  • Fax: 516-874-2477
Mailing address:
  • Phone: 516-608-1016
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number079106-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: