Healthcare Provider Details

I. General information

NPI: 1093532095
Provider Name (Legal Business Name): CHERYL LEKHANA PEREJI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/23/2024
Last Update Date: 09/23/2024
Certification Date: 09/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1130 TEN ROD RD STE 101
NORTH KINGSTOWN RI
02852-4161
US

IV. Provider business mailing address

11 SALINA AVE
JOHNSTON RI
02919-2524
US

V. Phone/Fax

Practice location:
  • Phone: 401-294-3990
  • Fax:
Mailing address:
  • Phone: 401-405-6559
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMHC00215-A
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: