Provider Demographics
NPI:1649555756
Name:MCLEAN, CHERYL ANNETTE (MSW, LCSW)
Entity type:Individual
Prefix:MS
First Name:CHERYL
Middle Name:ANNETTE
Last Name:MCLEAN
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:MRS
Other - First Name:CHERYL
Other - Middle Name:ANNETTE
Other - Last Name:MCLEAN-WIGGINS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSW, LCSW
Mailing Address - Street 1:834 NEILL SINCLAIR RD
Mailing Address - Street 2:
Mailing Address - City:RAEFORD
Mailing Address - State:NC
Mailing Address - Zip Code:28376-7447
Mailing Address - Country:US
Mailing Address - Phone:910-479-4651
Mailing Address - Fax:
Practice Address - Street 1:1318 RAEFORD RD
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28305-5482
Practice Address - Country:US
Practice Address - Phone:910-479-4651
Practice Address - Fax:855-857-7333
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-20
Last Update Date:2019-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0081131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1649555756Medicaid