Provider Demographics
NPI:1548400468
Name:DANIEL, CHERYL L (LCSW)
Entity Type:Individual
Prefix:MS
First Name:CHERYL
Middle Name:L
Last Name:DANIEL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:CHERYL
Other - Middle Name:L
Other - Last Name:ROBERTS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 22
Mailing Address - Street 2:
Mailing Address - City:CREWE
Mailing Address - State:VA
Mailing Address - Zip Code:23930-0022
Mailing Address - Country:US
Mailing Address - Phone:434-298-7530
Mailing Address - Fax:
Practice Address - Street 1:9101 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:AMELIA COURT HOUSE
Practice Address - State:VA
Practice Address - Zip Code:23002-4897
Practice Address - Country:US
Practice Address - Phone:804-561-5057
Practice Address - Fax:434-392-9221
Is Sole Proprietor?:No
Enumeration Date:2009-03-05
Last Update Date:2016-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040044691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA004945450Medicaid