Provider Demographics
NPI:1710359245
Name:MOCKLI, CHERIE (CSW)
Entity Type:Individual
Prefix:MS
First Name:CHERIE
Middle Name:
Last Name:MOCKLI
Suffix:
Gender:F
Credentials:CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 S 200 E
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84111-2438
Mailing Address - Country:US
Mailing Address - Phone:801-363-4596
Mailing Address - Fax:801-363-6068
Practice Address - Street 1:225 S 200 E
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84111-2438
Practice Address - Country:US
Practice Address - Phone:801-363-4596
Practice Address - Fax:801-363-6068
Is Sole Proprietor?:No
Enumeration Date:2015-10-23
Last Update Date:2015-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT9134977-3502104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker