Provider Demographics
NPI:1669979928
Name:CHIA CHERRE, ROBERTO W (NCC, LMHC)
Entity type:Individual
Prefix:
First Name:ROBERTO
Middle Name:W
Last Name:CHIA CHERRE
Suffix:
Gender:M
Credentials:NCC, LMHC
Other - Prefix:
Other - First Name:ROBERTO
Other - Middle Name:WILLIAM
Other - Last Name:CHIA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NCC, LMHC
Mailing Address - Street 1:525 COUNTRY CLUB LN
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:NY
Mailing Address - Zip Code:10970-2344
Mailing Address - Country:US
Mailing Address - Phone:845-558-8028
Mailing Address - Fax:
Practice Address - Street 1:161 N MIDDLETOWN RD
Practice Address - Street 2:
Practice Address - City:PEARL RIVER
Practice Address - State:NY
Practice Address - Zip Code:10965-2030
Practice Address - Country:US
Practice Address - Phone:845-219-1637
Practice Address - Fax:845-535-1275
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-11
Last Update Date:2018-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008576101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty