Provider Demographics
NPI:1801935150
Name:FACEMIRE, CHERYL KIM (MSW, LCSW-C)
Entity type:Individual
Prefix:MRS
First Name:CHERYL
Middle Name:KIM
Last Name:FACEMIRE
Suffix:
Gender:F
Credentials:MSW, LCSW-C
Other - Prefix:MS
Other - First Name:CHERYL
Other - Middle Name:KIM
Other - Last Name:GAVIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:6412 TISDALE TER
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817-1658
Mailing Address - Country:US
Mailing Address - Phone:301-875-5957
Mailing Address - Fax:
Practice Address - Street 1:208 MONROE ST
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-4401
Practice Address - Country:US
Practice Address - Phone:301-309-8200
Practice Address - Fax:301-309-9667
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2016-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD126461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD017589C22Medicare ID - Type UnspecifiedMEDICARE INDIVIDUAL NUMBE