Provider Demographics
NPI:1952593444
Name:MCHUNGUZI, CHERYL (LMSW)
Entity type:Individual
Prefix:MRS
First Name:CHERYL
Middle Name:
Last Name:MCHUNGUZI
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:MRS
Other - First Name:CHERYL
Other - Middle Name:
Other - Last Name:MCHUNGUZI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:51 PUTNAM AVE
Mailing Address - Street 2:
Mailing Address - City:WEST BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11704-1807
Mailing Address - Country:US
Mailing Address - Phone:631-219-6598
Mailing Address - Fax:
Practice Address - Street 1:26 COLONIAL SPRINGS RD
Practice Address - Street 2:
Practice Address - City:WHEATLEY HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11798-1015
Practice Address - Country:US
Practice Address - Phone:631-229-3688
Practice Address - Fax:631-229-3689
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-17
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP559561041C0700X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health