Individual
CHANTA BLUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1 UPPER MOUNTAIN AVE, MONTCLAIR, NJ 07042-1871
(201) 463-5084
Mailing address
1 UPPER MOUNTAIN AVE, MONTCLAIR, NJ 07042-1871
(201) 463-5084
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
44SC05703400
NJ
1041S0200X
School Social Worker
587336
NJ
Other
Enumeration date
11/09/2015
Last updated
09/11/2016
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