Provider Demographics
NPI:1043798853
Name:CEPHAS, SHAREEDA (PHD, CAC-AD)
Entity Type:Individual
Prefix:DR
First Name:SHAREEDA
Middle Name:
Last Name:CEPHAS
Suffix:
Gender:F
Credentials:PHD, CAC-AD
Other - Prefix:DR
Other - First Name:SHAREEDA
Other - Middle Name:
Other - Last Name:NIEVES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD, CAC-AD
Mailing Address - Street 1:PO BOX 996
Mailing Address - Street 2:
Mailing Address - City:ELKTON
Mailing Address - State:MD
Mailing Address - Zip Code:21922-0996
Mailing Address - Country:US
Mailing Address - Phone:302-593-3037
Mailing Address - Fax:
Practice Address - Street 1:2507 W 6TH ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19805-2908
Practice Address - Country:US
Practice Address - Phone:302-593-3037
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-02
Last Update Date:2018-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDAC1838101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)