Provider Demographics
NPI:1023667060
Name:CHAO, MARIETTE CELESTE (LCSW, CD (DONA))
Entity type:Individual
Prefix:
First Name:MARIETTE
Middle Name:CELESTE
Last Name:CHAO
Suffix:
Gender:F
Credentials:LCSW, CD (DONA)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4576 STUART ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80212-2540
Mailing Address - Country:US
Mailing Address - Phone:610-996-0381
Mailing Address - Fax:
Practice Address - Street 1:4576 STUART ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80212-2540
Practice Address - Country:US
Practice Address - Phone:610-996-0381
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-11
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCSW099285031041C0700X
CO15304374J00000X
PACW0205401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No374J00000XNursing Service Related ProvidersDoula