Provider Demographics
NPI:1710037239
Name:CHERNACK, KATHRYN B (DSW)
Entity type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:B
Last Name:CHERNACK
Suffix:
Gender:F
Credentials:DSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:383 RAYMOND ST
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570-2735
Mailing Address - Country:US
Mailing Address - Phone:516-594-0528
Mailing Address - Fax:516-594-9552
Practice Address - Street 1:233 7TH ST
Practice Address - Street 2:2ND FL, SUITE 200 #3
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-5747
Practice Address - Country:US
Practice Address - Phone:516-594-0528
Practice Address - Fax:516-594-9552
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPR0258841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical