Provider Demographics
NPI:1982904454
Name:HOVDESTAD, SHERI (MA, LPC, NCC)
Entity Type:Individual
Prefix:
First Name:SHERI
Middle Name:
Last Name:HOVDESTAD
Suffix:
Gender:F
Credentials:MA, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 STONERISE DR
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08648-5534
Mailing Address - Country:US
Mailing Address - Phone:609-795-7619
Mailing Address - Fax:
Practice Address - Street 1:100 HADDONTOWNE CT
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034-3602
Practice Address - Country:US
Practice Address - Phone:609-795-7619
Practice Address - Fax:609-435-1673
Is Sole Proprietor?:No
Enumeration Date:2010-10-29
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ527486OtherAGENCY MEDICARE PROVIDER #
NJ0023701OtherAGENCY MEDICAID PROVIDER #