Provider Demographics
NPI:1528262201
Name:SIRIANNI, CHELENE
Entity type:Individual
Prefix:
First Name:CHELENE
Middle Name:
Last Name:SIRIANNI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:445 S JENSEN RD
Mailing Address - Street 2:
Mailing Address - City:VESTAL
Mailing Address - State:NY
Mailing Address - Zip Code:13850-3018
Mailing Address - Country:US
Mailing Address - Phone:607-238-7928
Mailing Address - Fax:
Practice Address - Street 1:445 S JENSEN RD
Practice Address - Street 2:
Practice Address - City:VESTAL
Practice Address - State:NY
Practice Address - Zip Code:13850-3018
Practice Address - Country:US
Practice Address - Phone:607-238-7928
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-14
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002923-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health