Provider Demographics
NPI:1326749565
Name:SANDELL, CHERYL LYNNE
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:LYNNE
Last Name:SANDELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1717 W NORTHERN AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85021-5400
Mailing Address - Country:US
Mailing Address - Phone:602-254-9701
Mailing Address - Fax:602-755-1544
Practice Address - Street 1:1717 W NORTHERN AVE STE 101
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85021-5400
Practice Address - Country:US
Practice Address - Phone:602-254-9701
Practice Address - Fax:602-755-1544
Is Sole Proprietor?:No
Enumeration Date:2023-03-14
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)