Provider Demographics
NPI:1235799362
Name:HUTCHERSON, CHERISSE (LMHC)
Entity Type:Individual
Prefix:
First Name:CHERISSE
Middle Name:
Last Name:HUTCHERSON
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 1:5 BREWSTER ST # 569
Mailing Address - Street 2:
Mailing Address - City:GLEN COVE
Mailing Address - State:NY
Mailing Address - Zip Code:11542-2549
Mailing Address - Country:US
Mailing Address - Phone:516-308-1214
Mailing Address - Fax:
Practice Address - Street 1:5 BREWSTER ST # 569
Practice Address - Street 2:
Practice Address - City:GLEN COVE
Practice Address - State:NY
Practice Address - Zip Code:11542-2549
Practice Address - Country:US
Practice Address - Phone:516-308-1214
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-20
Last Update Date:2022-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009507101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health