Provider Demographics
NPI:1114300357
Name:SCHWAB, CHERISH NICOLE (BCBA)
Entity Type:Individual
Prefix:
First Name:CHERISH
Middle Name:NICOLE
Last Name:SCHWAB
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:CHERISH
Other - Middle Name:NICOLE
Other - Last Name:CHALK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6306 S MACDILL AVE APT 1704
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33611-5059
Mailing Address - Country:US
Mailing Address - Phone:321-848-3618
Mailing Address - Fax:
Practice Address - Street 1:815 S PARSONS AVE
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-6063
Practice Address - Country:US
Practice Address - Phone:941-263-1451
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-07
Last Update Date:2021-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-16-20339106S00000X
FL103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1620339OtherRBT