Provider Demographics
NPI:1700023785
Name:BUDDINGTON, CHERYL J (LCSW)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:J
Last Name:BUDDINGTON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:CHERYL
Other - Middle Name:
Other - Last Name:BOUCHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1070 E BATES PKWY
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80113-1714
Mailing Address - Country:US
Mailing Address - Phone:303-871-9889
Mailing Address - Fax:
Practice Address - Street 1:155 INVERNESS DR W
Practice Address - Street 2:SUITE 200
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80112-5095
Practice Address - Country:US
Practice Address - Phone:303-793-9634
Practice Address - Fax:303-889-0838
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-13
Last Update Date:2009-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9830031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO303773OtherPTANCO 303773