Provider Demographics
NPI:1972650182
Name:BORCK-HADLEY, CHERYL (MSW)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:
Last Name:BORCK-HADLEY
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:517 N SPRING MILL RD
Mailing Address - Street 2:
Mailing Address - City:VILLANOVA
Mailing Address - State:PA
Mailing Address - Zip Code:19085-1927
Mailing Address - Country:US
Mailing Address - Phone:610-804-0886
Mailing Address - Fax:
Practice Address - Street 1:517 N SPRING MILL RD
Practice Address - Street 2:
Practice Address - City:VILLANOVA
Practice Address - State:PA
Practice Address - Zip Code:19085-1927
Practice Address - Country:US
Practice Address - Phone:610-804-0886
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW002548L1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical