Provider Demographics
NPI:1881103257
Name:CHERNOFF, SOFIA MICHELLE (PSYD)
Entity type:Individual
Prefix:DR
First Name:SOFIA
Middle Name:MICHELLE
Last Name:CHERNOFF
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 BELMONT AVE STE 503
Mailing Address - Street 2:
Mailing Address - City:BALA CYNWYD
Mailing Address - State:PA
Mailing Address - Zip Code:19004-1608
Mailing Address - Country:US
Mailing Address - Phone:610-664-3020
Mailing Address - Fax:
Practice Address - Street 1:1 BELMONT AVE STE 503
Practice Address - Street 2:
Practice Address - City:BALA CYNWYD
Practice Address - State:PA
Practice Address - Zip Code:19004-1608
Practice Address - Country:US
Practice Address - Phone:610-664-3020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-28
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT10460712-2501103TH0004X, 103T00000X, 103TB0200X, 103TC0700X
PAPS019684103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealth
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical