Provider Demographics
NPI:1669018545
Name:DEW, CHERYL WOOTEN (BA, CSAC)
Entity Type:Individual
Prefix:MRS
First Name:CHERYL
Middle Name:WOOTEN
Last Name:DEW
Suffix:
Gender:F
Credentials:BA, CSAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1008 STARKHILL DR
Mailing Address - Street 2:
Mailing Address - City:KERNERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27284-2353
Mailing Address - Country:US
Mailing Address - Phone:336-575-3568
Mailing Address - Fax:
Practice Address - Street 1:3580 NC HIGHWAY 14
Practice Address - Street 2:
Practice Address - City:REIDSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27320-8746
Practice Address - Country:US
Practice Address - Phone:336-522-5095
Practice Address - Fax:336-450-4440
Is Sole Proprietor?:No
Enumeration Date:2019-11-26
Last Update Date:2019-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCCSAC-10538101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)