Chandi Louise Deitmer | Waltham, MA • PECOS Search

Chandi Louise Deitmer

Social Worker

Behavioral Health & Social Service Providers

77 4th Ave Ste 5, Waltham, MA 02451-7567

(781) 795-7252 (201) 281-2350

PECOS Enrollment

Based on the most recent information from CMS, provider Chandi Louise Deitmer does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 10:04 AM.

Profile Details

Provider ID
1285118257
Provider Type
Individual
Full Name
Deitmer, Chandi Louise
Credential
LICSW

Gender
Female
Sole Proprietor
No
Enumeration Date
9/17/2018
Last Updated
9/17/2018

Contact Information

Practice Location

77 4th Ave Ste 5, Waltham, MA 02451-7567

Unlisted Fax

Mailing Location

19 Chandler St Apt 3, Somerville, MA 02144-1911

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 1041C0700X Primary	Description Social Worker Behavioral Health & Social Service Providers	License 120004 Massachusetts