Provider Demographics
NPI:1003569740
Name:BOOKLESS, CHERISH DAWN
Entity Type:Individual
Prefix:
First Name:CHERISH
Middle Name:DAWN
Last Name:BOOKLESS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 MILLIGAN PL APT 2
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-8374
Mailing Address - Country:US
Mailing Address - Phone:347-607-7775
Mailing Address - Fax:
Practice Address - Street 1:60 DUFFIELD ST APT 8A
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-2270
Practice Address - Country:US
Practice Address - Phone:347-607-7775
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-02
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP112429101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty