Provider Demographics
NPI:1821972621
Name:ODEMENA, CHIKAODI (MHC-LP)
Entity type:Individual
Prefix:
First Name:CHIKAODI
Middle Name:
Last Name:ODEMENA
Suffix:
Gender:X
Credentials:MHC-LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3974 AMBOY RD STE 207
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10308-2414
Mailing Address - Country:US
Mailing Address - Phone:347-291-1011
Mailing Address - Fax:
Practice Address - Street 1:3974 AMBOY RD STE 207
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10308-2414
Practice Address - Country:US
Practice Address - Phone:347-291-1011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-04
Last Update Date:2025-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health