Provider Demographics
NPI:1760881189
Name:NIAMKE, CHAQUITA (PSYS)
Entity type:Individual
Prefix:MRS
First Name:CHAQUITA
Middle Name:
Last Name:NIAMKE
Suffix:
Gender:F
Credentials:PSYS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5110 ABIGAIL DR
Mailing Address - Street 2:
Mailing Address - City:LYNDHURST
Mailing Address - State:OH
Mailing Address - Zip Code:44124-1077
Mailing Address - Country:US
Mailing Address - Phone:216-273-6020
Mailing Address - Fax:
Practice Address - Street 1:3401 ENTERPRISE PKWY STE 340
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-7340
Practice Address - Country:US
Practice Address - Phone:216-273-6020
Practice Address - Fax:216-998-0246
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-21
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOH3151577103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool