Active NPI
Stephanie Laurence Cherubin, M.S., OTR/L
- Occupational Therapist
- Marietta, GA
National Provider Identifier
1184199416
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT007583
- Practice address
- 3024 Hidden Forest CT Unit 6314
Marietta, GA 30066-3160 - Phone
- (862) 888-2806
- Fax
- (678) 461-9804
- NPI assigned
- Oct 13, 2018
- Last updated
- Jan 3, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT007583 | GA | Primary |
| Occupational Therapist | 225X00000X | 022657 | NY | |
| Pediatric Occupational Therapist | 225XP0200X | 022657 | NY |
Addresses
Primary practice location
3024 Hidden Forest CT Unit 6314
Marietta, GA 30066-3160
Mailing address
3024 Hidden Forest CT Unit 6314
Marietta, GA 30066-3160
Phone (862) 888-2806
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 022657 | NY | MD | Clinical Neuropsychologist |
| OT007583 | GA | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Friendly Therapy LLC | Occupational Therapist | Current | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Occupational Therapist
- Marietta, GA
- NPI 1417632563
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1539388800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1704240000000",
"number": "1184199416",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3024 HIDDEN FOREST CT UNIT 6314",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300663160",
"telephone_number": "862-888-2806",
"fax_number": "678-461-9804"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3024 HIDDEN FOREST CT UNIT 6314",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300663160",
"telephone_number": "862-888-2806",
"fax_number": "678-461-9804"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHERUBIN",
"first_name": "STEPHANIE",
"middle_name": "LAURENCE",
"credential": "M.S., OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-10-13",
"last_updated": "2024-01-03",
"certification_date": "2024-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "GA",
"license": "OT007583",
"primary": true
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NY",
"license": "022657",
"primary": false
},
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "NY",
"license": "022657",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Marietta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.