Provider Demographics
NPI:1417159450
Name:GESREGAN, CHERYL ANNE (LCSW)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:ANNE
Last Name:GESREGAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:SHERRY
Other - Middle Name:
Other - Last Name:GESREGAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:922 ROUTE 518
Mailing Address - Street 2:
Mailing Address - City:SKILLMAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08558-2618
Mailing Address - Country:US
Mailing Address - Phone:609-688-8647
Mailing Address - Fax:609-497-2630
Practice Address - Street 1:905 HERRONTOWN RD
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-1901
Practice Address - Country:US
Practice Address - Phone:609-497-3348
Practice Address - Fax:609-497-2630
Is Sole Proprietor?:No
Enumeration Date:2007-06-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC00173000101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)