1912187998 NPI number — MS. CHERYL WASHINGTON LOVELL LCSWR

Table of content: MS. CHERYL WASHINGTON LOVELL LCSWR (NPI 1912187998)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1912187998 NPI number — MS. CHERYL WASHINGTON LOVELL LCSWR

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LOVELL
Provider First Name:
CHERYL
Provider Middle Name:
WASHINGTON
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LCSWR
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
RUSSELL
Provider Other First Name:
CHERYL
Provider Other Middle Name:
WASHINGTON
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1912187998
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/07/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3594 EAST TREMONT AVENUE
Provider Second Line Business Mailing Address:
ROOM 210
Provider Business Mailing Address City Name:
BRONX
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10465
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-792-4178
Provider Business Mailing Address Fax Number:
718-792-2496

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3594 EAST TREMONT AVENUE
Provider Second Line Business Practice Location Address:
ROOM 210
Provider Business Practice Location Address City Name:
BRONX
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10465
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-792-4178
Provider Business Practice Location Address Fax Number:
718-792-2496
Provider Enumeration Date:
11/07/2007

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:  074948 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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