Provider Demographics
NPI:1518351550
Name:JAMISON, CHERYL BURGESS (LISW-S)
Entity Type:Individual
Prefix:MS
First Name:CHERYL
Middle Name:BURGESS
Last Name:JAMISON
Suffix:
Gender:F
Credentials:LISW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5500 S MARGINAL RD STE 110
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44103-1009
Mailing Address - Country:US
Mailing Address - Phone:216-221-7588
Mailing Address - Fax:
Practice Address - Street 1:5500 S MARGINAL RD STE 110
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44103-1009
Practice Address - Country:US
Practice Address - Phone:216-221-7588
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-27
Last Update Date:2021-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.0003133-SUPV1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical