Provider Demographics
NPI:1225501901
Name:MCPHAIL, CHERYL (MS,BCBA)
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:
Last Name:MCPHAIL
Suffix:
Gender:F
Credentials:MS,BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 SPENCER ST
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32839-1449
Mailing Address - Country:US
Mailing Address - Phone:754-423-2392
Mailing Address - Fax:
Practice Address - Street 1:505 WINDY KNOLL DR UNIT 323
Practice Address - Street 2:
Practice Address - City:MOUNT AIRY
Practice Address - State:MD
Practice Address - Zip Code:21771-6614
Practice Address - Country:US
Practice Address - Phone:240-668-4415
Practice Address - Fax:240-673-6322
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-06
Last Update Date:2025-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLBA2021103K00000X
FL1-19-36169103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL022468900Medicaid