Individual provider · Type 1 NPI

Wanda Chisolm, LMHC, CASAC

Mental Health Counselor · East Islip, NY

NPI number 1629422639 Active

Practice location

107 East Main Street
East Islip, NY 11730

Call (631) 666-1615 Map

Mailing address

PO Box 1062
Bay Shore, NY 11706-0534

Other practice locations

  • 268 Delaware Ave, Bay Shore, NY 11706-3345 · (631) 328-1303

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor 101YA0400X23644 (NY)
Mental Health Counselor Primary 101YM0800X007206 (NY)

Mental Health Counselor: Definition to come...

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About NPI 1629422639

Wanda Chisolm, LMHC, CASAC's National Provider Identifier is 1629422639, issued on Apr 15, 2016. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in East Islip, NY. The record was last updated on Apr 16, 2019.