Provider Demographics
NPI:1578351920
Name:HERNANDEZ, CHERYL ELIZABETH (LMSW)
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:ELIZABETH
Last Name:HERNANDEZ
Suffix:
Gender:
Credentials:LMSW
Other - Prefix:
Other - First Name:CHERYL
Other - Middle Name:ELIZABETH
Other - Last Name:MANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:5800 HERITAGE LANDING DR STE E
Mailing Address - Street 2:
Mailing Address - City:EAST SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13057-9378
Mailing Address - Country:US
Mailing Address - Phone:315-396-8400
Mailing Address - Fax:
Practice Address - Street 1:5800 HERITAGE LANDING DR STE E
Practice Address - Street 2:
Practice Address - City:EAST SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13057-9378
Practice Address - Country:US
Practice Address - Phone:315-396-8400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-28
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY126890-01104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker