Provider Demographics
NPI:1437512464
Name:FAY, CHERYL (LCSW)
Entity Type:Individual
Prefix:MS
First Name:CHERYL
Middle Name:
Last Name:FAY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 EMORY ST UNIT 209
Mailing Address - Street 2:
Mailing Address - City:ASBURY PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07712-7131
Mailing Address - Country:US
Mailing Address - Phone:908-309-2737
Mailing Address - Fax:
Practice Address - Street 1:300 EMORY ST UNIT 209
Practice Address - Street 2:
Practice Address - City:ASBURY PARK
Practice Address - State:NJ
Practice Address - Zip Code:07712-7131
Practice Address - Country:US
Practice Address - Phone:908-309-2737
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-29
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC05635300101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health