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General NPI Number Information
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NPI Number | 1487251047
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Entity Type | Individual
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Provider Name | CHANTAL VICE
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Gender | Female
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Dates
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Enumeration Date | 10/07/2020
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Last Update Date | 01/20/2026
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Provider Practice Location Address
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Address Line | 68 S SERVICE RD STE 100
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City | MELVILLE
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State | NY
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Zip | 11747-2350
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Country | US
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Telephone | 516-430-8362
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Fax |
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Provider Business Mailing Address
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Address Line | 12 LOWERRE ST
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City | BABYLON
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State | NY
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Zip | 11702-2506
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Country | US
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Telephone | 917-538-7632
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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