William C Chidichimo, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW-24649 Issued in ID

Practice address

17TH Medical Operations Squadron
271 Ft Richardson Ave
Goodfellow Afb, TX 76908-4902

Phone

(325) 654-3122

NPI assigned

Oct 16, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Mr. Bill Chidichimo Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192406400000",
    "number": "1023198108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17TH MEDICAL OPERATIONS SQUADRON",
            "address_2": "271 FT RICHARDSON AVE",
            "city": "GOODFELLOW AFB",
            "state": "TX",
            "postal_code": "769084902",
            "telephone_number": "325-654-3122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17TH MEDICAL OPERATIONS SQUADRON",
            "address_2": "271 FT RICHARDSON AVE",
            "city": "GOODFELLOW AFB",
            "state": "TX",
            "postal_code": "769084902",
            "telephone_number": "325-654-3122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIDICHIMO",
        "first_name": "WILLIAM",
        "middle_name": "C",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2007-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "LCSW-24649",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BILL",
            "last_name": "CHIDICHIMO",
            "prefix": "MR.",
            "credential": "LCSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Ethan Scott Bannar, PSYD
• Matthew Thomas Bean
• Dale Andrew Beran, MD
• Alexander Briones-Hernandez, PHARMD
• Brett Logan Carr
• Pedro Colon
• Kristen Cooper, LCSW
• Kelly Erin Corbit, M-PAS, PA-C
• Mindy Courter, LCSW
• Michael Roy De Jesus, DNP, APRN, FNP-C

• Clinical Social Worker in Goodfellow Afb, TX
• Providers in Goodfellow Afb, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.