Individual provider Active NPI

Keri Chernuchin, PSY.D.

  • Psychologist
  • Syosset, NY
National Provider Identifier
1780185736
Registry record updated Jun 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
012853 Issued in NY
Practice address
485 Underhill Blvd Ste 101
Syosset, NY 11791-3434
Phone
(516) 921-0183
NPI assigned
Feb 26, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 012853 NY Primary

Addresses

Primary practice location

485 Underhill Blvd Ste 101
Syosset, NY 11791-3434

Mailing address

485 Underhill Blvd Ste 101
Syosset, NY 11791-3434
Phone (516) 921-0183

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

State licenses

LicenseStateTypeSpecialty
012853NYMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Keri Chernuchin, Psy.D. PLLC Psychologist CurrentSince Jun 11, 2023 Accepting new patients
Psychological Facts PLLC Psychologist CurrentSince Jun 11, 2023 Accepting new patients

Locations

485 Underhill Blvd
Ste 101
Syosset, NY 11791
Phone (516) 584-2741

485 Underhill Blvd
Ste 107
Syosset, NY 11791
Phone (516) 340-0444

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1519603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685923200000",
    "number": "1780185736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "485 UNDERHILL BLVD STE 101",
            "city": "SYOSSET",
            "state": "NY",
            "postal_code": "117913434",
            "telephone_number": "516-921-0183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "485 UNDERHILL BLVD STE 101",
            "city": "SYOSSET",
            "state": "NY",
            "postal_code": "117913434",
            "telephone_number": "516-921-0183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHERNUCHIN",
        "first_name": "KERI",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-26",
        "last_updated": "2023-06-05",
        "certification_date": "2022-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "012853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syosset, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.