Chisolm, Wanda

Chisolm, Wanda is an sole proprietor health care provider with primary practice located at 107 East Main Street , East Islip NY 11730. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. Chisolm, Wanda can be contacted via phone (631) 666-1615.

Contact Information

Primary practice address
107 East Main Street East Islip NY 11730
Phone: (631) 666-1615
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 23644 New York
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 007206 New York

Profile Details

NPI number 1629422639
LBN Legal business name Chisolm, Wanda
Credentials LMHC, CASAC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 15th, 2016
Last updated Apr 16th, 2019 - about 5 years 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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