Provider Demographics
NPI:1538253745
Name:CHERNEY, CAROL SUE (MS CRC G&C)
Entity type:Individual
Prefix:MS
First Name:CAROL
Middle Name:SUE
Last Name:CHERNEY
Suffix:
Gender:F
Credentials:MS CRC G&C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:N10326 STATE ROAD 79
Mailing Address - Street 2:
Mailing Address - City:BOYCEVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:54725-9408
Mailing Address - Country:US
Mailing Address - Phone:715-643-2141
Mailing Address - Fax:
Practice Address - Street 1:808 MAIN ST E
Practice Address - Street 2:
Practice Address - City:MENOMONIE
Practice Address - State:WI
Practice Address - Zip Code:54751-2735
Practice Address - Country:US
Practice Address - Phone:715-232-1116
Practice Address - Fax:715-232-5987
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health