Provider Demographics
NPI:1053561217
Name:CHIVENEY, JOSEPH PAUL (MA, LMHC (CMHS))
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:PAUL
Last Name:CHIVENEY
Suffix:
Gender:M
Credentials:MA, LMHC (CMHS)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:307 PERCIVAL ST NW
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98502-4933
Mailing Address - Country:US
Mailing Address - Phone:206-437-0071
Mailing Address - Fax:253-922-0910
Practice Address - Street 1:307 PERCIVAL ST NW
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98502-4933
Practice Address - Country:US
Practice Address - Phone:206-437-0071
Practice Address - Fax:253-922-0910
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-24
Last Update Date:2017-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00011190101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1980994Medicaid