Provider Demographics
NPI:1336631878
Name:CHILLE, KATHERINE (LCSW, LISW-CP)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:CHILLE
Suffix:
Gender:F
Credentials:LCSW, LISW-CP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1007 CALEDON CT
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-3189
Mailing Address - Country:US
Mailing Address - Phone:516-512-0072
Mailing Address - Fax:
Practice Address - Street 1:30 PATEWOOD DR STE 160
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-6809
Practice Address - Country:US
Practice Address - Phone:843-501-1099
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-31
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY089769-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker