Provider Demographics
NPI:1073522165
Name:JONES-HOLADAY, CHERYL (LCSW)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:
Last Name:JONES-HOLADAY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:770 EAST MAIN STREET
Mailing Address - Street 2:SUITE 1A
Mailing Address - City:MOORESTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08057-3040
Mailing Address - Country:US
Mailing Address - Phone:856-234-0470
Mailing Address - Fax:856-722-0564
Practice Address - Street 1:770E MAIN ST 1A
Practice Address - Street 2:
Practice Address - City:MOORESTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08057
Practice Address - Country:US
Practice Address - Phone:856-234-0470
Practice Address - Fax:856-722-0564
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-07
Last Update Date:2015-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC003655001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ458444000OtherMAGELLAN MIS NUMBER
NJP00267666OtherRAILROAD MEDICARE NUMBER
NJ7589086OtherAETNA PIN NUMBER
NJP00267666OtherRAILROAD MEDICARE NUMBER