Provider Demographics
NPI:1992938781
Name:CHERYL DOUCETTE, ANP-BC, PMHCNS-BC, LLC
Entity type:Organization
Organization Name:CHERYL DOUCETTE, ANP-BC, PMHCNS-BC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL NURSE SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:DOUCETTE
Authorized Official - Suffix:
Authorized Official - Credentials:ANP-BC, PMHCNS-BC
Authorized Official - Phone:978-521-8810
Mailing Address - Street 1:62 BROWN ST
Mailing Address - Street 2:SUITE 505
Mailing Address - City:HAVERHILL
Mailing Address - State:MA
Mailing Address - Zip Code:01830-6778
Mailing Address - Country:US
Mailing Address - Phone:978-521-8810
Mailing Address - Fax:978-521-8811
Practice Address - Street 1:62 BROWN ST
Practice Address - Street 2:SUITE 505
Practice Address - City:HAVERHILL
Practice Address - State:MA
Practice Address - Zip Code:01830-6778
Practice Address - Country:US
Practice Address - Phone:978-521-8810
Practice Address - Fax:978-521-8811
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-27
Last Update Date:2009-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA216207364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental HealthGroup - Single Specialty