Provider Demographics
NPI:1669941969
Name:CHAMBERS, CHERYL DENISE
Entity type:Individual
Prefix:MRS
First Name:CHERYL
Middle Name:DENISE
Last Name:CHAMBERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9070 MAIN ST
Mailing Address - Street 2:CHRISTIAN COUNSELING MINISTRIES OF WNY
Mailing Address - City:CLARENCE
Mailing Address - State:NY
Mailing Address - Zip Code:14031
Mailing Address - Country:US
Mailing Address - Phone:716-632-3200
Mailing Address - Fax:716-632-3233
Practice Address - Street 1:9070 MAIN ST
Practice Address - Street 2:CHRISTIAN COUNSELING MINISTRIES OF WNY
Practice Address - City:CLARENCE
Practice Address - State:NY
Practice Address - Zip Code:14031
Practice Address - Country:US
Practice Address - Phone:716-632-3200
Practice Address - Fax:716-632-3233
Is Sole Proprietor?:No
Enumeration Date:2018-11-15
Last Update Date:2018-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001365101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health