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General NPI Number Information
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NPI Number | 1790437556
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Entity Type | Individual
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Provider Name | JOHN MICHAEL CHERNESKY
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Gender | Male
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Dates
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Enumeration Date | 01/24/2022
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Last Update Date | 01/24/2022
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Provider Practice Location Address
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Address Line | 64 WALL ST STE 200
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City | NORWALK
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State | CT
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Zip | 06850-3403
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Country | US
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Telephone | 855-284-7483
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Fax | 617-807-0958
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Provider Business Mailing Address
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Address Line | 1000 JEFFERSON ST STE 2C
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City | LYNCHBURG
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State | VA
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Zip | 24504-1724
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Country | US
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Telephone | 855-284-7483
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Fax | 617-807-0958
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 5051
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License Number State | CT
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