Provider Demographics
NPI:1306375985
Name:ENSTAD, CHERYL NOEL RICHARDS (MSW, LICSW)
Entity Type:Individual
Prefix:MRS
First Name:CHERYL
Middle Name:NOEL RICHARDS
Last Name:ENSTAD
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:CHERYL
Other - Middle Name:NOEL
Other - Last Name:RICHARDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3926 LAKEMONT RD
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98226-8621
Mailing Address - Country:US
Mailing Address - Phone:360-296-5693
Mailing Address - Fax:
Practice Address - Street 1:1155 N STATE ST
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-5037
Practice Address - Country:US
Practice Address - Phone:360-296-5693
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-07
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW601556221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical