Provider Demographics
NPI:1073951141
Name:CHERNOSKY, GINA (LICSW)
Entity Type:Individual
Prefix:
First Name:GINA
Middle Name:
Last Name:CHERNOSKY
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 COMMERCE DR STE 305
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03110-6946
Mailing Address - Country:US
Mailing Address - Phone:603-883-0005
Mailing Address - Fax:603-883-0007
Practice Address - Street 1:8 COMMERCE DR STE 305
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:NH
Practice Address - Zip Code:03110-6946
Practice Address - Country:US
Practice Address - Phone:603-883-0005
Practice Address - Fax:603-883-0007
Is Sole Proprietor?:No
Enumeration Date:2013-06-11
Last Update Date:2022-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH26711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical