Provider Demographics
NPI:1952625246
Name:STANDRIDGE, CHERISA (LCSW)
Entity type:Individual
Prefix:MS
First Name:CHERISA
Middle Name:
Last Name:STANDRIDGE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:CHERISA
Other - Middle Name:
Other - Last Name:DEBOLT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:UNIT 33100 BOX LRMC
Mailing Address - Street 2:US ARMY HEALTH CLINIC BAUMHOLDER
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09034
Mailing Address - Country:DE
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:UNIT 33100 BOX LRMC
Practice Address - Street 2:
Practice Address - City:APO
Practice Address - State:RHINELAND PFALZ
Practice Address - Zip Code:09034
Practice Address - Country:DE
Practice Address - Phone:314-590-1032
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-16
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
OK43531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical