Provider Demographics
NPI:1194974071
Name:NIANGANE, CHAVONNE CASSANDRA (MSW)
Entity type:Individual
Prefix:
First Name:CHAVONNE
Middle Name:CASSANDRA
Last Name:NIANGANE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:CHAVONNE
Other - Middle Name:CASSANDRA
Other - Last Name:CAMPBELL-NIANGANE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSW
Mailing Address - Street 1:5445 OAKLAND ST
Mailing Address - Street 2:
Mailing Address - City:PHILA
Mailing Address - State:PA
Mailing Address - Zip Code:19124-1210
Mailing Address - Country:US
Mailing Address - Phone:267-303-3512
Mailing Address - Fax:
Practice Address - Street 1:5445 OAKLAND ST
Practice Address - Street 2:
Practice Address - City:PHILA
Practice Address - State:PA
Practice Address - Zip Code:19124-1210
Practice Address - Country:US
Practice Address - Phone:267-303-3512
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-16
Last Update Date:2008-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker