Provider Demographics
NPI:1710773189
Name:JEROME, CHANTELE
Entity type:Individual
Prefix:MRS
First Name:CHANTELE
Middle Name:
Last Name:JEROME
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:CHANTELE
Other - Middle Name:
Other - Last Name:JEROME
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW
Mailing Address - Street 1:1029 COHANNET ST
Mailing Address - Street 2:
Mailing Address - City:TAUNTON
Mailing Address - State:MA
Mailing Address - Zip Code:02780-4316
Mailing Address - Country:US
Mailing Address - Phone:774-297-4249
Mailing Address - Fax:774-297-4249
Practice Address - Street 1:68 ALLISON AVE
Practice Address - Street 2:
Practice Address - City:TAUNTON
Practice Address - State:MA
Practice Address - Zip Code:02780-6958
Practice Address - Country:US
Practice Address - Phone:774-297-4249
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-15
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker