Provider Demographics
NPI:1891726832
Name:COVIELLO, CHERYL (LICSW)
Entity Type:Individual
Prefix:MS
First Name:CHERYL
Middle Name:
Last Name:COVIELLO
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61 SYLVESTER ST
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01843-3619
Mailing Address - Country:US
Mailing Address - Phone:617-512-2601
Mailing Address - Fax:
Practice Address - Street 1:BEDFORD VAMC 122
Practice Address - Street 2:200 SPRINGS RD.
Practice Address - City:BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:01730
Practice Address - Country:US
Practice Address - Phone:781-687-2706
Practice Address - Fax:781-687-3179
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1135091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical