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NPI Code Detail

MEDICARE: LISA MICHELE CHITTENDEN

MEDICARE: LISA MICHELE CHITTENDEN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerI.2507493OH

General Provider Information

NPI Number : 1831841998
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA MICHELE CHITTENDEN
Provider Business Mailing Address
First Line : 2000 NOBLE DR
Second Line :
City : WOOSTER
State : OH
Zip : 44691-5353
Country : US
Telephone Number : 330-264-3232
Fax Number : 330-264-3879
Provider Business Practice Location Address
First Line : 104 SPINK ST
Second Line :
City : WOOSTER
State : OH
Zip : 44691-3652
Country : US
Telephone Number : 330-264-8498
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/20/2022
Last Update Date : 01/20/2026

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Directions to “ LISA MICHELE CHITTENDEN ” Practice Location

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