Jill Chiciak, ATR-BC, LPAT

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

408 S White Horse Pike
Audubon, NJ 08106-1311

Phone

(856) 693-5775

NPI assigned

Mar 3, 2015

Last updated

Jul 17, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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": "1425340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721174400000",
    "number": "1134511876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 LUPTON AVE",
            "city": "WOODBURY",
            "state": "NJ",
            "postal_code": "080965901",
            "telephone_number": "856-693-5775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 S WHITE HORSE PIKE",
            "city": "AUDUBON",
            "state": "NJ",
            "postal_code": "081061311",
            "telephone_number": "856-693-5775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHICIAK",
        "first_name": "JILL",
        "name_prefix": "Ms.",
        "credential": "ATR-BC, LPAT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-03",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "221700000X",
            "taxonomy_group": "",
            "desc": "Art Therapist",
            "state": "NJ",
            "license": "16LP00008100",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0996025",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Elizabeth Engle Corcory
• Danielle Cranmer, LSW
• Douglas Raymond Crawford, ED.D.

• Mental Health Counselor in Audubon, NJ
• Providers in Audubon, NJ by specialty
• Mental Health Counselor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2024; 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.