MEDICARE: JEREMY CHISUM LCSW

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
1	1041C0700X	Clinical Social Worker	CWS.09924004	CO

General Provider Information

NPI Number	:	1932608726
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEREMY CHISUM LCSW

Provider Business Mailing Address
First Line	:	7254 AMBER RIDGE DR
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80922-2417
Country	:	US
Telephone Number	:	719-761-4005
Fax Number	:

Provider Business Practice Location Address
First Line	:	7254 AMBER RIDGE DR
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80922-2417
Country	:	US
Telephone Number	:	719-761-4005
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/07/2018
Last Update Date	:	02/07/2018

Similar Medicare Providers

1467966432 — THERAPY WORKS
Practice Location Address:

1834 GRANT AVE
COLORADO SPRINGS, CO
80909-2417

Practice Phone: 516-578-8967
Practice Fax:

1770470742 — ASHLEIGH DE'ERIN LUTUI
Practice Location Address:

4116 HUSTED MILL CT
COLORADO SPRINGS, CO
80910-2417

Practice Phone: 719-209-4081
Practice Fax:

1912959362 — RICHARD BRUCE BANNON MD
Practice Location Address:

391 GLENN SPRINGS RD
PACOLET, SC
29372-2417

Practice Phone: 864-474-3013
Practice Fax: 864-474-1501

1629090568 — MARY BLACK HEALTH SYSTEM LLC
Practice Location Address:

391 GLENN SPRINGS RD
PACOLET, SC
29372-2417

Practice Phone: 864-474-3013
Practice Fax:

1902988983 — MARY BLACK PHYSICIANS GROUP, LLC
Practice Location Address:

391 GLENN SPRINGS RD
PACOLET, SC
29372-2417

Practice Phone: 864-703-1414
Practice Fax: 864-703-1419

1518185396 — MARY BLACK PHYSICIANS GROUP LLC
Practice Location Address:

391 GLENN SPRINGS RD
PACOLET, SC
29372-2417

Practice Phone: 864-474-3013
Practice Fax:

Directions to “ JEREMY CHISUM LCSW” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.