Provider Demographics
NPI:1083029813
Name:TCHERNIAKOVSKAIA, DARIA (LMHC)
Entity Type:Individual
Prefix:
First Name:DARIA
Middle Name:
Last Name:TCHERNIAKOVSKAIA
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:147 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:WELLESLEY
Mailing Address - State:MA
Mailing Address - Zip Code:02481
Mailing Address - Country:US
Mailing Address - Phone:617-759-2004
Mailing Address - Fax:405-632-1976
Practice Address - Street 1:13 EATON COURT
Practice Address - Street 2:
Practice Address - City:WELLESLEY
Practice Address - State:MA
Practice Address - Zip Code:02481
Practice Address - Country:US
Practice Address - Phone:617-759-2004
Practice Address - Fax:781-302-4635
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-01
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9987101YM0800X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health