Healthcare Provider Details

I. General information

NPI: 1588155618
Provider Name (Legal Business Name): CHENNEY DEJESUS M.A., CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHENNEY VASSI M.A., CCC-SLP

II. Dates (important events)

Enumeration Date: 05/24/2018
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 BRICE ST
AMSTERDAM NY
12010-5101
US

IV. Provider business mailing address

19 GRANT AVE
AMSTERDAM NY
12010-3413
US

V. Phone/Fax

Practice location:
  • Phone: 518-843-2871
  • Fax:
Mailing address:
  • Phone: 518-817-5492
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number029729
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: