Provider Demographics
NPI:1285769232
Name:JOSEPH CHERIES PSY D PL
Entity type:Organization
Organization Name:JOSEPH CHERIES PSY D PL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:CHERIES
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:772-589-7680
Mailing Address - Street 1:1515 US HIGHWAY 1
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SEBASTIAN
Mailing Address - State:FL
Mailing Address - Zip Code:32958-1612
Mailing Address - Country:US
Mailing Address - Phone:772-589-7680
Mailing Address - Fax:772-589-9294
Practice Address - Street 1:1515 US HIGHWAY 1
Practice Address - Street 2:SUITE 201
Practice Address - City:SEBASTIAN
Practice Address - State:FL
Practice Address - Zip Code:32958-1612
Practice Address - Country:US
Practice Address - Phone:772-589-7680
Practice Address - Fax:772-589-9294
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY7389103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL90150OtherBLUE CROSS
FL90150OtherBLUE CROSS