Provider Demographics
NPI:1366512261
Name:CHIMIENTI, NICHOLAS (LCSW)
Entity type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:
Last Name:CHIMIENTI
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1202 MAPLE HILL ROAD
Mailing Address - Street 2:
Mailing Address - City:SCOTCH PLAINS
Mailing Address - State:NJ
Mailing Address - Zip Code:07076
Mailing Address - Country:US
Mailing Address - Phone:908-654-6450
Mailing Address - Fax:908-654-6450
Practice Address - Street 1:137 GARFIELD PLACE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215
Practice Address - Country:US
Practice Address - Phone:718-832-5297
Practice Address - Fax:908-654-6450
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR02420411041C0700X
NJ44SC002652001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical