Provider Demographics
NPI:1710099320
Name:CHERNUS, LINDA A (MSW)
Entity Type:Individual
Prefix:PROF
First Name:LINDA
Middle Name:A
Last Name:CHERNUS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4201 VICTORY PKWY
Mailing Address - Street 2:#915
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229-1645
Mailing Address - Country:US
Mailing Address - Phone:513-558-9004
Mailing Address - Fax:513-558-3880
Practice Address - Street 1:4201 VICTORY PKWY
Practice Address - Street 2:#915
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229-1645
Practice Address - Country:US
Practice Address - Phone:513-558-9004
Practice Address - Fax:513-558-3880
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHSW04662Medicare ID - Type Unspecified