Chiciak, Jill

Chiciak, Jill is an individual health care provider with primary practice located at 408 S White Horse Pike , Audubon NJ 08106-1311. She recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Art Therapist, Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. Chiciak, Jill can be contacted via phone (856) 693-5775.

Contact Information

Primary practice address
408 S White Horse Pike Audubon NJ 08106-1311
Phone: (856) 693-5775
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Art Therapist 221700000X 16LP00008100 New Jersey
Behavioral Health & Social Service Providers / Mental Health 101YM0800X

Profile Details

NPI number 1134511876
LBN Legal business name Chiciak, Jill
Credentials ATR-BC, LPAT
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 3rd, 2015
Last updated Jul 17th, 2024 - about 5 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1134511876 NPPES
New Jersey MEDICAID 0996025

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