Provider Demographics
NPI:1215808654
Name:CERNERA, ANTHONY AARON
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:AARON
Last Name:CERNERA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 SUNNYRIDGE AVE APT 11
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06824-4644
Mailing Address - Country:US
Mailing Address - Phone:203-613-3122
Mailing Address - Fax:
Practice Address - Street 1:2228 BLACK ROCK TPKE STE 202
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06825-3237
Practice Address - Country:US
Practice Address - Phone:203-613-3122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-17
Last Update Date:2025-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT8883101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health