Provider Demographics
NPI:1104168111
Name:SHIFLETT, CHERYL L (PHD)
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:L
Last Name:SHIFLETT
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 936
Mailing Address - Street 2:EVMS MEDICAL GROUP
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23501-0936
Mailing Address - Country:US
Mailing Address - Phone:757-446-5888
Mailing Address - Fax:757-446-5918
Practice Address - Street 1:825 FAIRFAX AVE
Practice Address - Street 2:SUITE 710
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23507-1914
Practice Address - Country:US
Practice Address - Phone:757-446-5888
Practice Address - Fax:757-446-5918
Is Sole Proprietor?:No
Enumeration Date:2013-03-18
Last Update Date:2013-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701004426101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1104168111OtherVIRGINIA PREMIER HEALTH PLAN
VA1104168111Medicaid
VAPAROtherUSA MANAGED CARE
VA1104168111OtherUNITED BEHAVIORAL HEALTH
VAPAROtherVIRGINIA HEALTH NETWORK
VA1104168111OtherOPTIMA BEHAVIORAL HEALTH
VAPAROtherMULTIPLAN
VAPAROtherAETNA
VAPAROtherCIGNA BEHAVIORAL HEALTH
VA1104168111OtherMANAGED HEALTH NETWORK
VAPAROtherMAGELLAN HEALTH SERVICES
VA490917OtherANTHEM BEHAVIORAL HEALTH
VAPAROtherCORVEL