Provider Demographics
NPI:1306428073
Name:CHERRY, JOSEFINA NICOLE (LMSW)
Entity type:Individual
Prefix:MRS
First Name:JOSEFINA
Middle Name:NICOLE
Last Name:CHERRY
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 GLENBROOK RD APT 321
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06902-2873
Mailing Address - Country:US
Mailing Address - Phone:914-844-5476
Mailing Address - Fax:
Practice Address - Street 1:1074 MIDLAND AVE
Practice Address - Street 2:
Practice Address - City:BRONXVILLE
Practice Address - State:NY
Practice Address - Zip Code:10708-6352
Practice Address - Country:US
Practice Address - Phone:914-844-5476
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-22
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY108905104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker