Provider Demographics
NPI:1811196330
Name:BIANCHI-BIGELOW, CHERYL A (LCSW-R,ACSW)
Entity Type:Individual
Prefix:MS
First Name:CHERYL
Middle Name:A
Last Name:BIANCHI-BIGELOW
Suffix:
Gender:F
Credentials:LCSW-R,ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 EAST AVE
Mailing Address - Street 2:SUITE104
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14610-1657
Mailing Address - Country:US
Mailing Address - Phone:585-232-3120
Mailing Address - Fax:585-719-9148
Practice Address - Street 1:1501 EAST AVE
Practice Address - Street 2:SUITE104
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14610-1657
Practice Address - Country:US
Practice Address - Phone:585-232-3120
Practice Address - Fax:585-719-9148
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-14
Last Update Date:2007-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR03429911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX7905358OtherAETNA PIN