Provider Demographics
NPI:1740546969
Name:STROUD, CHERYL LYNN (MSW, LCSW)
Entity type:Individual
Prefix:MRS
First Name:CHERYL
Middle Name:LYNN
Last Name:STROUD
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:412 QUIET FIELD DR
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERS
Mailing Address - State:MO
Mailing Address - Zip Code:63376-3870
Mailing Address - Country:US
Mailing Address - Phone:636-240-7111
Mailing Address - Fax:
Practice Address - Street 1:1284 JUNGERMANN RD STE B
Practice Address - Street 2:
Practice Address - City:SAINT PETERS
Practice Address - State:MO
Practice Address - Zip Code:63376-6966
Practice Address - Country:US
Practice Address - Phone:636-498-0700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-02
Last Update Date:2012-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20110001051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical