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General NPI Number Information
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NPI Number | 1285952945
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Entity Type | Individual
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Provider Name | CHERYL DIANE STICKEL LSW, BCBA
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Gender | Female
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Dates
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Enumeration Date | 05/05/2010
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Last Update Date | 09/01/2010
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Provider Practice Location Address
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Address Line | 2 W WASHINGTON AVE SUITE 212
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City | WASHINGTON
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State | NJ
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Zip | 07882-1917
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Country | US
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Telephone | 908-884-3207
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Fax | 908-835-8300
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Provider Business Mailing Address
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Address Line | 2 W WASHINGTON AVE SUITE 212
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City | WASHINGTON
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State | NJ
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Zip | 07882-1917
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Country | US
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Telephone | 908-884-3207
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Fax | 908-835-8300
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 44SL05205200
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 44SL05205200
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License Number State | NJ
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