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General NPI Number Information
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NPI Number | 1932610409
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Entity Type | Individual
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Provider Name | CHERYL LYNN LODDO LCSW LCADC
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Gender | Female
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Dates
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Enumeration Date | 10/23/2017
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Last Update Date | 03/30/2018
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Provider Practice Location Address
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Address Line | 629 E WOOD ST STE 305
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City | VINELAND
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State | NJ
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Zip | 08360-3731
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Country | US
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Telephone | 856-462-0585
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Fax |
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Provider Business Mailing Address
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Address Line | 300 COLUMBINE AVE
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City | MILLVILLE
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State | NJ
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Zip | 08332-4069
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Country | US
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Telephone | 609-408-9102
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 37LC00229700
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 44SC05747100
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License Number State | NJ
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