Individual
CHUCK CICHANOWICZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMHC,MS,M.DIV,IMAC,
Contact information
Practice address
3768 ROME DRIVE, LAFAYETTE, IN 47905
(765) 449-9115
(765) 446-4224
Mailing address
106 CANDLELIGHT PLZ, WEST LAFAYETTE BRA, IN 47906-5628
(765) 449-9117
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
39000389A
IN
Other
Enumeration date
10/24/2006
Last updated
07/08/2007
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