Healthcare Provider Details

I. General information

NPI: 1275053647
Provider Name (Legal Business Name): JESSICA ELIZABETH CHEVERINO ATR-BC, LCAT, CASAC2
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2017
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

46 ROWLAND ST
PATCHOGUE NY
11772-1630
US

IV. Provider business mailing address

46 ROWLAND ST
PATCHOGUE NY
11772-1630
US

V. Phone/Fax

Practice location:
  • Phone: 516-320-3140
  • Fax:
Mailing address:
  • Phone: 516-320-3140
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code221700000X
TaxonomyArt Therapist
License Number002291
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: