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Contact Information

PATRICK J CHESEBROUGH, LCAC
4618 E STATE BLVD STE 300
FORT WAYNE, IN46815-6966
 Phone: 260-373-0213
 Fax: 260-373-0218
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Addiction (Substance Use Disorder)

101YA0400X
Indicates primary specialty

NPI Profile & details for PATRICK J CHESEBROUGH · (Male)

NPI Number 1265001457
Status Active
Credentials LCAC
Entity Individual
Enumeration date 06/22/2021
Last updated 06/22/2021 - About 5 years ago
Sole proprietor 1 No
Identifiers
  • IN License # 87001654A
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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