Provider Demographics
NPI:1467600692
Name:CHERRY, WILLIAM SCOTT (LCSW)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:SCOTT
Last Name:CHERRY
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:252 OLD CANTERBURY TPKE LOT 107
Mailing Address - Street 2:
Mailing Address - City:NORWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06360-1389
Mailing Address - Country:US
Mailing Address - Phone:860-705-3921
Mailing Address - Fax:
Practice Address - Street 1:252 OLD CANTERBURY TPKE LOT 107
Practice Address - Street 2:
Practice Address - City:NORWICH
Practice Address - State:CT
Practice Address - Zip Code:06360-1389
Practice Address - Country:US
Practice Address - Phone:860-705-3921
Practice Address - Fax:860-889-0926
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-29
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0059261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical