Provider Demographics
NPI:1528488095
Name:CHERY-REED, VIERGELYN (MA, LMHC, ET)
Entity type:Individual
Prefix:MRS
First Name:VIERGELYN
Middle Name:
Last Name:CHERY-REED
Suffix:
Gender:F
Credentials:MA, LMHC, ET
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 WATER ST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02109-4206
Mailing Address - Country:US
Mailing Address - Phone:857-600-2449
Mailing Address - Fax:
Practice Address - Street 1:112 WATER ST
Practice Address - Street 2:SUITE 203
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02109-4206
Practice Address - Country:US
Practice Address - Phone:857-600-2449
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-23
Last Update Date:2017-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
MA10077101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator