1548400468 NPI number — MS. CHERYL L DANIEL LCSW

Table of content: MS. CHERYL L DANIEL LCSW (NPI 1548400468)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1548400468 NPI number — MS. CHERYL L DANIEL LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DANIEL
Provider First Name:
CHERYL
Provider Middle Name:
L
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ROBERTS
Provider Other First Name:
CHERYL
Provider Other Middle Name:
L
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1548400468
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/20/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 22
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CREWE
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23930-0022
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
434-298-7530
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9101 WASHINGTON ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
AMELIA COURT HOUSE
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23002-4897
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
804-561-5057
Provider Business Practice Location Address Fax Number:
434-392-9221
Provider Enumeration Date:
03/05/2009

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  0904004469 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 004945450 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".




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