Healthcare Provider Details

I. General information

NPI: 1548400468
Provider Name (Legal Business Name): CHERYL L DANIEL LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. CHERYL L ROBERTS

II. Dates (important events)

Enumeration Date: 03/05/2009
Last Update Date: 01/20/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9101 WASHINGTON ST
AMELIA COURT HOUSE VA
23002-4897
US

IV. Provider business mailing address

PO BOX 22
CREWE VA
23930-0022
US

V. Phone/Fax

Practice location:
  • Phone: 804-561-5057
  • Fax: 434-392-9221
Mailing address:
  • Phone: 434-298-7530
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904004469
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: