Provider Demographics
NPI:1215291521
Name:CHICHA, EMANUEL (MA)
Entity type:Individual
Prefix:
First Name:EMANUEL
Middle Name:
Last Name:CHICHA
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 ARCADIA PARK
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02122-1402
Mailing Address - Country:US
Mailing Address - Phone:617-407-2724
Mailing Address - Fax:
Practice Address - Street 1:8 ARCADIA PARK
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02122-1402
Practice Address - Country:US
Practice Address - Phone:617-407-2724
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-02
Last Update Date:2012-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor