Provider Demographics
NPI:1639507742
Name:CHERYL M. CEBULA, MSW PLLC
Entity Type:Organization
Organization Name:CHERYL M. CEBULA, MSW PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:CEBULA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:206-328-9871
Mailing Address - Street 1:2910 E MADISON ST # 211
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98112-4214
Mailing Address - Country:US
Mailing Address - Phone:206-328-9871
Mailing Address - Fax:
Practice Address - Street 1:2910 E MADISON ST # 211
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98112-4214
Practice Address - Country:US
Practice Address - Phone:206-328-9871
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-29
Last Update Date:2013-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW000047241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty