Provider Demographics
NPI:1003987975
Name:SCIACCA, CHERI (LCSWR, CASAC)
Entity Type:Individual
Prefix:MS
First Name:CHERI
Middle Name:
Last Name:SCIACCA
Suffix:
Gender:F
Credentials:LCSWR, CASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 WILL TREMPER DR
Mailing Address - Street 2:
Mailing Address - City:RHINEBECK
Mailing Address - State:NY
Mailing Address - Zip Code:12572-1811
Mailing Address - Country:US
Mailing Address - Phone:845-876-4898
Mailing Address - Fax:
Practice Address - Street 1:239 GOLDEN HILL LN
Practice Address - Street 2:ULSTER COUNTY MENTAL HEALTH DEPARTMENT
Practice Address - City:KINGSTON
Practice Address - State:NY
Practice Address - Zip Code:12401-6441
Practice Address - Country:US
Practice Address - Phone:845-340-4123
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR037331-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY5779OtherCASAC
NYN3K571Medicare ID - Type Unspecified
NYR037331-1Medicare UPIN