Provider Demographics
NPI:1992328710
Name:KINNEY, CHERYL (LCSW)
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:
Last Name:KINNEY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:CHERLY
Other - Middle Name:
Other - Last Name:WINGBERMUEHLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:1237 WARSON WOODS DR
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63122-1735
Mailing Address - Country:US
Mailing Address - Phone:314-608-2527
Mailing Address - Fax:
Practice Address - Street 1:623 MERAMEC STATION RD
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:MO
Practice Address - Zip Code:63021-5550
Practice Address - Country:US
Practice Address - Phone:314-266-9131
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-27
Last Update Date:2020-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0052881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical