Provider Demographics
NPI:1801956529
Name:MANDEL-REICHGUT, CHERIE (MSW)
Entity type:Individual
Prefix:MRS
First Name:CHERIE
Middle Name:
Last Name:MANDEL-REICHGUT
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 1:1B SEAVIEW AVE
Mailing Address - Street 2:#14
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06460-5204
Mailing Address - Country:US
Mailing Address - Phone:203-876-7945
Mailing Address - Fax:
Practice Address - Street 1:80 FERRY BLVD
Practice Address - Street 2:SUITE 204
Practice Address - City:STRATFORD
Practice Address - State:CT
Practice Address - Zip Code:06615-6079
Practice Address - Country:US
Practice Address - Phone:203-378-1654
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT003171101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health