Provider Demographics
NPI:1770078800
Name:SCHOELL, CHERYL LYNN (LSW)
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:LYNN
Last Name:SCHOELL
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 EVESBORO MEDFORD RD STE H
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-3865
Mailing Address - Country:US
Mailing Address - Phone:856-834-0135
Mailing Address - Fax:
Practice Address - Street 1:906 BETHLEHEM PIKE
Practice Address - Street 2:
Practice Address - City:ERDENHEIM
Practice Address - State:PA
Practice Address - Zip Code:19038-7731
Practice Address - Country:US
Practice Address - Phone:856-834-0135
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-01
Last Update Date:2018-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1760774046Medicaid