Individual provider Active NPI

Sherrille Chole McKethan

  • Clinical Social Worker
  • Cherry Hill, NJ
National Provider Identifier
1245016302
Registry record updated Apr 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC06306400 Issued in NJ
Practice address
1060 Kings Hwy N
Cherry Hill, NJ 08034-1910
Phone
(856) 285-5861
NPI assigned
Sep 5, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 25, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Mental Health Counselor 101YM0800X 44SL06271400 NJ
Clinical Social Worker 1041C0700X 44SC06306400 NJ Primary

Addresses

Primary practice location

1060 Kings Hwy N
Cherry Hill, NJ 08034-1910

Mailing address

69 Middlebury LN
Willingboro, NJ 08046-2931
Phone (973) 896-1723

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
44SL06271400NJMDMental Health Counselor
44SC06306400NJMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1693872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714003200000",
    "number": "1245016302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "69 MIDDLEBURY LN",
            "city": "WILLINGBORO",
            "state": "NJ",
            "postal_code": "080462931",
            "telephone_number": "973-896-1723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1060 KINGS HWY N",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080341910",
            "telephone_number": "856-285-5861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKETHAN",
        "first_name": "SHERRILLE",
        "middle_name": "CHOLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-05",
        "last_updated": "2024-04-25",
        "certification_date": "2024-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NJ",
            "license": "44SL06271400",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC06306400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cherry Hill, NJ

Sources for this page

Verify at the official NPI Registry.