Provider Demographics
NPI:1609199611
Name:PIERRE-JEAN, CHERNIKA MICHELLE (LMHC, LADC1, CADC)
Entity Type:Individual
Prefix:
First Name:CHERNIKA
Middle Name:MICHELLE
Last Name:PIERRE-JEAN
Suffix:
Gender:F
Credentials:LMHC, LADC1, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:895 BLUE HILL AVE
Mailing Address - Street 2:
Mailing Address - City:DORCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:02124-2902
Mailing Address - Country:US
Mailing Address - Phone:617-822-7142
Mailing Address - Fax:617-822-7149
Practice Address - Street 1:895 BLUE HILL AVE
Practice Address - Street 2:
Practice Address - City:DORCHESTER
Practice Address - State:MA
Practice Address - Zip Code:02124-2902
Practice Address - Country:US
Practice Address - Phone:617-822-7142
Practice Address - Fax:617-822-7149
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-04
Last Update Date:2019-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA11478101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health