Provider Demographics
NPI:1588392658
Name:BADCHKAM, CHARDONNAY L (LMHC)
Entity type:Individual
Prefix:MS
First Name:CHARDONNAY
Middle Name:L
Last Name:BADCHKAM
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15020 72ND RD APT 1B
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367-2103
Mailing Address - Country:US
Mailing Address - Phone:718-839-2241
Mailing Address - Fax:
Practice Address - Street 1:34 PLAZA ST E
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11238-5038
Practice Address - Country:US
Practice Address - Phone:646-490-1930
Practice Address - Fax:646-809-8580
Is Sole Proprietor?:No
Enumeration Date:2022-08-08
Last Update Date:2022-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012827101YM0800X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health