Provider Demographics
NPI:1427350362
Name:SYBESMA VAN NOORD, CHERYL KAY (PHD, LP)
Entity type:Individual
Prefix:DR
First Name:CHERYL
Middle Name:KAY
Last Name:SYBESMA VAN NOORD
Suffix:
Gender:F
Credentials:PHD, LP
Other - Prefix:DR
Other - First Name:CHERYL
Other - Middle Name:
Other - Last Name:SYBESMA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD, LP
Mailing Address - Street 1:8009 34TH AVE S
Mailing Address - Street 2:RIVERVIEW OFFICE TOWER, SUITE 1490
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55425-1608
Mailing Address - Country:US
Mailing Address - Phone:612-408-5857
Mailing Address - Fax:
Practice Address - Street 1:8009 34TH AVE S
Practice Address - Street 2:RIVERVIEW OFFICE TOWER, SUITE 1490
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55425-1608
Practice Address - Country:US
Practice Address - Phone:612-408-5857
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-29
Last Update Date:2017-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5285103TC2200X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical