Provider Demographics
NPI:1003410226
Name:CONEY, CHERYL DELYNN
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:DELYNN
Last Name:CONEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44840 MILESTONE SQ APT 202
Mailing Address - Street 2:
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20147-4219
Mailing Address - Country:US
Mailing Address - Phone:412-614-1941
Mailing Address - Fax:
Practice Address - Street 1:20955 PROFESSIONAL PLZ STE 310
Practice Address - Street 2:
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20147-3405
Practice Address - Country:US
Practice Address - Phone:571-257-3378
Practice Address - Fax:571-257-0906
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-29
Last Update Date:2020-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0733007161101YM0800X
VA0732001489101YM0800X
VA0704010696101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health