Provider Demographics
NPI:1649439837
Name:SOPO, CHERYL ANN (LCSW)
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:ANN
Last Name:SOPO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 NEW YORK AVE
Mailing Address - Street 2:
Mailing Address - City:WHITING
Mailing Address - State:IN
Mailing Address - Zip Code:46394-1716
Mailing Address - Country:US
Mailing Address - Phone:219-473-1344
Mailing Address - Fax:219-844-4885
Practice Address - Street 1:1800 NEW YORK AVE
Practice Address - Street 2:
Practice Address - City:WHITING
Practice Address - State:IN
Practice Address - Zip Code:46394-1716
Practice Address - Country:US
Practice Address - Phone:219-473-1737
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-03
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34004231A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200085310Medicaid
IN200085310Medicaid