Provider Demographics
NPI:1508699471
Name:CHETNEY, ERICA NICOLE (LMSW)
Entity type:Individual
Prefix:MISS
First Name:ERICA
Middle Name:NICOLE
Last Name:CHETNEY
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:223 BRATTLE RD
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13203-1320
Mailing Address - Country:US
Mailing Address - Phone:315-401-1454
Mailing Address - Fax:
Practice Address - Street 1:5700 W GENESEE ST STE 118
Practice Address - Street 2:
Practice Address - City:CAMILLUS
Practice Address - State:NY
Practice Address - Zip Code:13031-3218
Practice Address - Country:US
Practice Address - Phone:315-488-1641
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-24
Last Update Date:2024-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1243321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical