Provider Demographics
NPI:1023407863
Name:SPAULDING, CHERYL ANN (MA, LMSW)
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:ANN
Last Name:SPAULDING
Suffix:
Gender:F
Credentials:MA, LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18300 PRATT RD
Mailing Address - Street 2:
Mailing Address - City:ARMADA
Mailing Address - State:MI
Mailing Address - Zip Code:48005-1150
Mailing Address - Country:US
Mailing Address - Phone:586-784-5632
Mailing Address - Fax:
Practice Address - Street 1:18300 PRATT RD
Practice Address - Street 2:
Practice Address - City:ARMADA
Practice Address - State:MI
Practice Address - Zip Code:48005-1150
Practice Address - Country:US
Practice Address - Phone:586-784-5632
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-16
Last Update Date:2015-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010145071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical