Provider Demographics
NPI:1134316730
Name:PRIDE, CHERYL C I (MSW, LCSW)
Entity Type:Individual
Prefix:MS
First Name:CHERYL
Middle Name:C
Last Name:PRIDE
Suffix:I
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 MARTER AVE
Mailing Address - Street 2:SUITE 406
Mailing Address - City:MOORESTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08057-3124
Mailing Address - Country:US
Mailing Address - Phone:856-778-3111
Mailing Address - Fax:856-231-7484
Practice Address - Street 1:110 MARTER AVE
Practice Address - Street 2:SUITE 406
Practice Address - City:MOORESTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08057-3124
Practice Address - Country:US
Practice Address - Phone:856-778-3111
Practice Address - Fax:856-231-7484
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-27
Last Update Date:2007-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC011655001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical