Provider Demographics
NPI:1104914753
Name:PARMELY, CHERYL (EDD)
Entity type:Individual
Prefix:DR
First Name:CHERYL
Middle Name:
Last Name:PARMELY
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 590303
Mailing Address - Street 2:
Mailing Address - City:NEWTON CENTRE
Mailing Address - State:MA
Mailing Address - Zip Code:02459-0003
Mailing Address - Country:US
Mailing Address - Phone:617-332-0369
Mailing Address - Fax:617-332-5149
Practice Address - Street 1:11 WARREN TER
Practice Address - Street 2:
Practice Address - City:NEWTON CENTRE
Practice Address - State:MA
Practice Address - Zip Code:02459-2060
Practice Address - Country:US
Practice Address - Phone:617-332-0369
Practice Address - Fax:617-332-5149
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1044103T00000X
MO2003023470103T00000X
MA1783103TH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAW02690Medicare ID - Type Unspecified
MA531693Medicare UPIN