Provider Demographics
NPI:1164592952
Name:SANDERS, CHERYL MOTLEY (MSW UCSW)
Entity Type:Individual
Prefix:MS
First Name:CHERYL
Middle Name:MOTLEY
Last Name:SANDERS
Suffix:
Gender:F
Credentials:MSW UCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 SUMMER STREET
Mailing Address - Street 2:PO BOX 80215
Mailing Address - City:STONEHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02180
Mailing Address - Country:US
Mailing Address - Phone:781-438-4166
Mailing Address - Fax:781-438-1493
Practice Address - Street 1:108 SUMMER STREET
Practice Address - Street 2:
Practice Address - City:STONEHAM
Practice Address - State:MA
Practice Address - Zip Code:02180
Practice Address - Country:US
Practice Address - Phone:781-438-4166
Practice Address - Fax:781-438-1493
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA101880011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA231350Medicaid
MA231350Medicaid