Provider Demographics
NPI:1215072681
Name:CHERIES, JOSEPH EDWARD (PSY D)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:EDWARD
Last Name:CHERIES
Suffix:
Gender:
Credentials:PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 OMRS/SGXW
Mailing Address - Street 2:1370 SOUTH PATRICK DRIVE
Mailing Address - City:PATRICK SFB
Mailing Address - State:FL
Mailing Address - Zip Code:32925
Mailing Address - Country:US
Mailing Address - Phone:321-494-8234
Mailing Address - Fax:
Practice Address - Street 1:45 MDOS/SGOW
Practice Address - Street 2:1370 SOUTH PATRICK DRIVE
Practice Address - City:PATRICK AFB
Practice Address - State:FL
Practice Address - Zip Code:32925
Practice Address - Country:US
Practice Address - Phone:321-494-8234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY 7389103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPY 7389OtherLICENSE
FL90150OtherBLUE CROSS
FLAC471ZMedicare PIN