Provider Demographics
NPI:1013030055
Name:KING-MARINO, CHERYL (LSW)
Entity Type:Individual
Prefix:MS
First Name:CHERYL
Middle Name:
Last Name:KING-MARINO
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:910 RED COAT FARM DR
Mailing Address - Street 2:
Mailing Address - City:CHALFONT
Mailing Address - State:PA
Mailing Address - Zip Code:18914-4402
Mailing Address - Country:US
Mailing Address - Phone:215-290-4596
Mailing Address - Fax:
Practice Address - Street 1:54 E OAKLAND AVE
Practice Address - Street 2:
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901-4651
Practice Address - Country:US
Practice Address - Phone:215-348-4002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW003791E104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker