Provider Demographics
NPI:1316972177
Name:LANEY, CHERYL EWING (PSYD)
Entity type:Individual
Prefix:DR
First Name:CHERYL
Middle Name:EWING
Last Name:LANEY
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:CHERYL
Other - Middle Name:EWING
Other - Last Name:BIEMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:30 WASHINGTON AVE STE F
Mailing Address - Street 2:
Mailing Address - City:HADDONFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:08033-3341
Mailing Address - Country:US
Mailing Address - Phone:856-354-9423
Mailing Address - Fax:856-427-9964
Practice Address - Street 1:30 WASHINGTON AVE STE F
Practice Address - Street 2:
Practice Address - City:HADDONFIELD
Practice Address - State:NJ
Practice Address - Zip Code:08033-3341
Practice Address - Country:US
Practice Address - Phone:856-354-9423
Practice Address - Fax:856-427-9964
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2009-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1905103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPS002675OtherCLINICAL PSYCHOLOGIST
TAX ID 222812769OtherTAX ID
NJ1905OtherCLINICAL PSYCHOLOGIST