Provider Demographics
NPI:1700282878
Name:CHERYL HECHT, LCSW, PLLC
Entity Type:Organization
Organization Name:CHERYL HECHT, LCSW, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MS
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:HECHT
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:631-428-3799
Mailing Address - Street 1:606 JOHNSON AVE
Mailing Address - Street 2:STE 12
Mailing Address - City:BOHEMIA
Mailing Address - State:NY
Mailing Address - Zip Code:11716-2686
Mailing Address - Country:US
Mailing Address - Phone:631-428-3799
Mailing Address - Fax:631-750-9457
Practice Address - Street 1:606 JOHNSON AVE
Practice Address - Street 2:STE 12
Practice Address - City:BOHEMIA
Practice Address - State:NY
Practice Address - Zip Code:11716-2686
Practice Address - Country:US
Practice Address - Phone:631-428-3799
Practice Address - Fax:631-750-9457
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-17
Last Update Date:2015-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY08-2218-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA100122455Medicare PIN