Provider Demographics
NPI:1043779259
Name:CHEATHAM, NALINI (LCMHC)
Entity type:Individual
Prefix:
First Name:NALINI
Middle Name:
Last Name:CHEATHAM
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 FISHER POND RD
Mailing Address - Street 2:
Mailing Address - City:SAINT ALBANS
Mailing Address - State:VT
Mailing Address - Zip Code:05478-6286
Mailing Address - Country:US
Mailing Address - Phone:802-524-6554
Mailing Address - Fax:802-524-6562
Practice Address - Street 1:107 FISHER POND RD
Practice Address - Street 2:
Practice Address - City:SAINT ALBANS
Practice Address - State:VT
Practice Address - Zip Code:05478-6286
Practice Address - Country:US
Practice Address - Phone:802-524-6554
Practice Address - Fax:802-524-6562
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-18
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
VT068-0127274101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty