Provider Demographics
NPI:1699394957
Name:SMALLEY, CHERI MICHELLE (LISW)
Entity Type:Individual
Prefix:
First Name:CHERI
Middle Name:MICHELLE
Last Name:SMALLEY
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 S WYANDOTTE AVE
Mailing Address - Street 2:
Mailing Address - City:CAREY
Mailing Address - State:OH
Mailing Address - Zip Code:43316-1320
Mailing Address - Country:US
Mailing Address - Phone:440-821-7313
Mailing Address - Fax:
Practice Address - Street 1:125 S WYANDOTTE AVE
Practice Address - Street 2:
Practice Address - City:CAREY
Practice Address - State:OH
Practice Address - Zip Code:43316-1320
Practice Address - Country:US
Practice Address - Phone:440-821-7313
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-15
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.20020731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical