Provider Demographics
NPI:1730137852
Name:HOOVER, CHERYL A (LCSW, BCD)
Entity Type:Individual
Prefix:MS
First Name:CHERYL
Middle Name:A
Last Name:HOOVER
Suffix:
Gender:F
Credentials:LCSW, BCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 REITZ BOULEVARD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:LEWISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17837
Mailing Address - Country:US
Mailing Address - Phone:570-524-0881
Mailing Address - Fax:570-524-9738
Practice Address - Street 1:11 REITZ BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:LEWISBURG
Practice Address - State:PA
Practice Address - Zip Code:17837-9293
Practice Address - Country:US
Practice Address - Phone:570-524-0881
Practice Address - Fax:570-524-9738
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0133451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA059811Medicare ID - Type Unspecified