National Provider Identifier

Roberta Darlene Cheatham, LMSW

Roberta Darlene Cheatham, LMSW is listed in the NPPES registry with a primary specialty of Professional Counselor in Elmira, NY and a listed phone number of (607) 215-3619.

NPI 1649839499Elmira, NYProfessional Counselor

Profile Overview

NPI
1649839499
Provider Type
Individual
Primary Specialty
Professional Counselor
Enumeration Date
June 06, 2019
Last Updated
January 19, 2024

Practice Location

  • 101 Franklin St
  • Elmira, NY 14904-1737

Phone: (607) 215-3619

Specialties

  • Professional Counselor (101YP2500X)
  • Professional Counselor (101YP2500X)
Full Record
NPI
1649839499
Entity Type
Individual
Last Name
Cheatham
First Name
Roberta
Middle Name
Darlene
Credential
LMSW
Provider Other Last Name
Cheatham
Provider Other First Name
Roberta
Provider Other Name Prefix Text
Miss
Provider Other Credential Text
ROBERTA CHEATHAM
Provider Other Last Name Type Code
2
Mailing Street Address
101 Franklin St
Mailing City
Elmira
Mailing State
NY
Mailing ZIP Code
14904-1737
Mailing Country
US
Mailing Phone
(607) 215-3619
Practice Street Address
101 Franklin St
Practice City
Elmira
Practice State
NY
Practice ZIP Code
14904-1737
Practice Country
US
Practice Phone
(607) 215-3619
Enumeration Date
June 06, 2019
Last Updated
January 19, 2024
Deactivation Date
October 21, 2020
Reactivation Date
January 19, 2024
Sex
Female
Sole Proprietor
Yes
Taxonomy Group 1
193400000X Single Specialty Group
Certification Date
October 21, 2020
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Professional Counselor (101YP2500X), Professional Counselor (101YP2500X)