| Benita K Chernyk, Ph.d., Llc | |
|
5005 Rockside Rd Crown Centre Ste 600 Independence OH 44131-6837 | |
| (216) 382-2929 | |
| (216) 465-2829 |
| Full Name | Benita K Chernyk, Ph.d., Llc |
|---|---|
| Speciality | Psychologist |
| Location | 5005 Rockside Rd, Independence, Ohio |
| Authorized Official Name and Position | Benita K Chernyk (PRESIDENT/ OWNER) |
| Authorized Official Contact | 2163822929 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Benita K Chernyk, Ph.d., Llc Po Box 202653 Cleveland OH 44120-8127 Ph: (216) 382-2929 | Benita K Chernyk, Ph.d., Llc 5005 Rockside Rd Crown Centre Ste 600 Independence OH 44131-6837 Ph: (216) 382-2929 |
| NPI Number | 1902492499 |
|---|---|
| Provider Enumeration Date | 12/18/2020 |
| Last Update Date | 08/26/2024 |
| Certification Date | 08/26/2024 |
| Medicare PECOS PAC ID | 4183027154 |
|---|---|
| Medicare Enrollment ID | O20210728002192 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902492499 | NPI | - | NPPES |
| 0825727 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Benita K Chernyk |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1902810328 PECOS PAC ID: 6608762448 Enrollment ID: I20170307002722 |
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