Healthcare Provider Details

I. General information

NPI: 1275917197
Provider Name (Legal Business Name): CHERYL WHITE-GRIER DUKES LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2015
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date: 11/29/2024
Reactivation Date: 05/26/2026

III. Provider practice location address

571 CLEARVIEW DR
LONG POND PA
18334-7735
US

IV. Provider business mailing address

571 CLEARVIEW DR
LONG POND PA
18334-7735
US

V. Phone/Fax

Practice location:
  • Phone: 917-636-2251
  • Fax:
Mailing address:
  • Phone: 917-636-2251
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number125792
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: