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General NPI Number Information
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NPI Number | 1144002429
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Entity Type | Individual
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Provider Name | CHERYL L STASHKEVETCH LCSW
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Gender | Female
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Dates
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Enumeration Date | 10/19/2023
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Last Update Date | 10/19/2023
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Provider Practice Location Address
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Address Line | 271 MERCER ST
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City | PRINCETON
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State | NJ
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Zip | 08540-4803
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Country | US
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Telephone | 732-259-6847
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Fax |
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Provider Business Mailing Address
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Address Line | 271 MERCER ST
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City | PRINCETON
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State | NJ
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Zip | 08540-4803
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Country | US
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Telephone | 732-259-6847
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 44SC05694400
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 1041S0200X
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Taxonomy Name | School Social Worker
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License Number | 01700613
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License Number State | NJ
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Taxonomy #4
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 44SC05694400
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License Number State | NJ
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