Individual provider Active NPI

Alicia Michelle Cherrybon, LCSW

  • Clinical Social Worker
  • Tallahassee, FL
National Provider Identifier
1104242171
Registry record updated Jan 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW13357 Issued in FL
Practice address
1310 Cross Creek Cir
Suite a
Tallahassee, FL 32301-8062
Phone
(850) 877-4228
Fax
(888) 700-6760
NPI assigned
Mar 13, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 29, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW13357 FL Primary

Addresses

Primary practice location

1310 Cross Creek Cir
Suite a
Tallahassee, FL 32301-8062

Mailing address

1310 Cross Creek Cir
Suite a
Tallahassee, FL 32301-8062
Phone (850) 877-4228

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
SW13357FLMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1394668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454025600000",
    "number": "1104242171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 CROSS CREEK CIR",
            "address_2": "SUITE A",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323018062",
            "telephone_number": "850-877-4228",
            "fax_number": "888-700-6760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 CROSS CREEK CIR",
            "address_2": "SUITE A",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323018062",
            "telephone_number": "850-877-4228",
            "fax_number": "888-700-6760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHERRYBON",
        "first_name": "ALICIA",
        "middle_name": "MICHELLE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-03-13",
        "last_updated": "2016-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW13357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.