MEDICARE: GINA CHERNOSKY LICSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	2671	NH

General Provider Information

NPI Number	:	1073951141
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GINA CHERNOSKY LICSW

Provider Business Mailing Address
First Line	:	4800 N SCOTTSDALE RD STE 2500
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85251-7630
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8 COMMERCE DR STE 305
Second Line	:
City	:	BEDFORD
State	:	NH
Zip	:	03110-6946
Country	:	US
Telephone Number	:	603-883-0005
Fax Number	:	603-883-0007

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/11/2013
Last Update Date	:	12/04/2024

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