person
Wanda Chisolm, LMHC,CASAC
Mental Health Counselor in East Islip, New York
NPI 1629422639

Wanda Chisolm is a Mental Health Counselor based in Bay Shore, NY and is specialized in Mental Health. Wanda Chisolm practices in East Islip, NY and has the professional credentials of LMHC,CASAC. The NPI Number for Wanda Chisolm is 1629422639 and holds a License No. 23644 (New York).

The current practice location address for Wanda Chisolm is 107 East Main Street, East Islip, NY and can be reached out via phone at 631-666-1615.

Location: 107 East Main Street, East Islip, NY, 11706-0534
person
Provider Profile Details
NPI Number
1629422639
Provider Name
Wanda Chisolm
Credential
LMHC,CASAC
Provider Entity Type
Individual
Gender
Female
Address
107 East Main Street, East Islip, NY, 11706-0534
Phone Number
631-666-1615
Fax Number
Provider Enumeration Date
04/15/2016
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
107 East Main Street
City
State
Zip
11730
Phone Number
631-666-1615
Fax Number
person
Provider Business Mailing Address Details
Address
107 East Main Street
City
State
Zip
11730
Phone Number
631-666-1615
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
007206 (New York)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
License No.
23644 (New York)
Definition
Definition to come...
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