Provider Demographics
NPI:1144002429
Name:STASHKEVETCH, CHERYL L (LCSW)
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:L
Last Name:STASHKEVETCH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:CHERYL
Other - Middle Name:LYNN
Other - Last Name:LANGFELD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:271 MERCER ST
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-4803
Mailing Address - Country:US
Mailing Address - Phone:732-259-6847
Mailing Address - Fax:
Practice Address - Street 1:271 MERCER ST
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-4803
Practice Address - Country:US
Practice Address - Phone:732-259-6847
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-19
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X, 171400000X
NJ44SC05694400104100000X, 1041C0700X
NJ017006131041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool
No171400000XOther Service ProvidersHealth & Wellness Coach