Provider Demographics
NPI:1528364650
Name:CHICHESTER, MARCIA PAMELA (LCSW-R)
Entity type:Individual
Prefix:MS
First Name:MARCIA
Middle Name:PAMELA
Last Name:CHICHESTER
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:678 NORTHERN PKWY
Mailing Address - Street 2:
Mailing Address - City:UNIONDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11553-3522
Mailing Address - Country:US
Mailing Address - Phone:516-305-9872
Mailing Address - Fax:
Practice Address - Street 1:RXR PLAZA
Practice Address - Street 2:SUITE 405
Practice Address - City:UNIONDALE
Practice Address - State:NY
Practice Address - Zip Code:11556
Practice Address - Country:US
Practice Address - Phone:516-548-2386
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-08
Last Update Date:2019-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR049686-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical