Provider Demographics
NPI:1831166941
Name:DOVAL, CHERI YVONNE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:CHERI
Middle Name:YVONNE
Last Name:DOVAL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4799 CALENDULA AVE
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURG
Mailing Address - State:FL
Mailing Address - Zip Code:32068-5411
Mailing Address - Country:US
Mailing Address - Phone:904-884-0880
Mailing Address - Fax:
Practice Address - Street 1:4799 CALENDULA AVE
Practice Address - Street 2:
Practice Address - City:MIDDLEBURG
Practice Address - State:FL
Practice Address - Zip Code:32068-5411
Practice Address - Country:US
Practice Address - Phone:904-884-0880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-07
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW79621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO36499011OtherBC BS
MO49762304Medicaid
MOD54E357Medicare ID - Type Unspecified