Provider Demographics
NPI:1528343647
Name:BERARDINELLI, SHERYL (PSYD)
Entity type:Individual
Prefix:DR
First Name:SHERYL
Middle Name:
Last Name:BERARDINELLI
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 TOWNSHIP LINE RD
Mailing Address - Street 2:SUITE 28
Mailing Address - City:ELKINS PARK
Mailing Address - State:PA
Mailing Address - Zip Code:19027-2220
Mailing Address - Country:US
Mailing Address - Phone:215-663-6077
Mailing Address - Fax:
Practice Address - Street 1:60 TOWNSHIP LINE RD
Practice Address - Street 2:SUITE 28
Practice Address - City:ELKINS PARK
Practice Address - State:PA
Practice Address - Zip Code:19027-2220
Practice Address - Country:US
Practice Address - Phone:215-663-6077
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-20
Last Update Date:2015-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ4881103G00000X, 103TP2701X, 103TC0700X
PAPS016980103G00000X, 103TC0700X, 103TP2701X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup Psychotherapy