Provider Demographics
NPI:1528435047
Name:CHANTEL GINEO
Entity type:Organization
Organization Name:CHANTEL GINEO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:CHANTEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GINEO
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LPC
Authorized Official - Phone:860-637-6559
Mailing Address - Street 1:105 HIGHLAND TER
Mailing Address - Street 2:
Mailing Address - City:NEW BRITAIN
Mailing Address - State:CT
Mailing Address - Zip Code:06053-2432
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:50 ALBANY TPKE
Practice Address - Street 2:SUITE 3010
Practice Address - City:CANTON
Practice Address - State:CT
Practice Address - Zip Code:06019-2516
Practice Address - Country:US
Practice Address - Phone:860-637-6559
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-01
Last Update Date:2015-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002799101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty