Individual
CHASITY NICOLE CARRERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LISW
Contact information
Practice address
901 E MAIN ST, LEIPSIC, OH 45856-9326
(419) 999-2010
(419) 999-6284
Mailing address
1100 SHAWNEE RD, LIMA, OH 45805-3529
(419) 999-2010
(419) 999-6284
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
I.1000325-SUPV
OH
1041C0700X
Clinical Social Worker
Primary
S.1000325-SUPV
OH
1041C0700X
Clinical Social Worker
S0031200
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0220584
—
OH
Enumeration date
08/11/2008
Last updated
11/09/2021
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