Provider Demographics
NPI:1487864104
Name:SMITH, CHERYL ANN
Entity Type:Individual
Prefix:MS
First Name:CHERYL
Middle Name:ANN
Last Name:SMITH
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 1:40 PRINCETON LN
Mailing Address - Street 2:
Mailing Address - City:WILLINGBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08046-2739
Mailing Address - Country:US
Mailing Address - Phone:856-278-9683
Mailing Address - Fax:
Practice Address - Street 1:833 CHESTNUT ST STE 1100
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-4413
Practice Address - Country:US
Practice Address - Phone:267-507-3897
Practice Address - Fax:609-396-8420
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health