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General NPI Number Information
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NPI Number | 1942471032
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Entity Type | Individual
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Provider Name | MICHELE R CHINICHIAN LCSW
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Gender | Female
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Dates
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Enumeration Date | 03/17/2008
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Last Update Date | 03/11/2016
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Provider Practice Location Address
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Address Line | 1415 N 1ST ST
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City | PHOENIX
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State | AZ
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Zip | 85004-1604
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Country | US
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Telephone | 602-302-7815
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Fax | 602-258-6140
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Provider Business Mailing Address
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Address Line | 793 N ALMA SCHOOL RD STE D6
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City | CHANDLER
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State | AZ
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Zip | 85224-3611
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Country | US
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Telephone | 480-409-2915
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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 | LCSW-11578
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License Number State | AZ
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