Provider Demographics
NPI:1740794726
Name:VOPAL, CHERYL (CAPSW)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:
Last Name:VOPAL
Suffix:
Gender:F
Credentials:CAPSW
Other - Prefix:
Other - First Name:CHERYL
Other - Middle Name:
Other - Last Name:STARMACH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:S78W18465 LIONS PARK DR
Mailing Address - Street 2:
Mailing Address - City:MUSKEGO
Mailing Address - State:WI
Mailing Address - Zip Code:53150-8704
Mailing Address - Country:US
Mailing Address - Phone:414-736-5436
Mailing Address - Fax:
Practice Address - Street 1:15350 W NATIONAL AVE
Practice Address - Street 2:
Practice Address - City:NEW BERLIN
Practice Address - State:WI
Practice Address - Zip Code:53151-5158
Practice Address - Country:US
Practice Address - Phone:262-797-7979
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-28
Last Update Date:2017-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1916-1211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical