Provider Demographics
NPI:1356427264
Name:LITT, CHERYL (LICSW BCD)
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:
Last Name:LITT
Suffix:
Gender:F
Credentials:LICSW BCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1350 BELMONT ST
Mailing Address - Street 2:STE 107
Mailing Address - City:BROCKTON
Mailing Address - State:MA
Mailing Address - Zip Code:02301-4430
Mailing Address - Country:US
Mailing Address - Phone:508-586-1600
Mailing Address - Fax:
Practice Address - Street 1:1350 BELMONT ST
Practice Address - Street 2:STE 107
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02301-4430
Practice Address - Country:US
Practice Address - Phone:508-586-1600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-31
Last Update Date:2012-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1033441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
095063OtherMHN
052600000OtherMAGELLAN MIS NUMBER
0004131865OtherAETNA
MALIP01899OtherBCBS
899601OtherHARVARD PILGRIM
780065OtherTUFTS
88040OtherCIGNA
014698OtherVALUE OPTIONS
665712OtherTUFTS
MALIP01899OtherBCBS
R41503Medicare UPIN