Individual provider Active NPI

Cheryl Lee McDermott

  • Social Worker
  • Bloomington, IN
National Provider Identifier
1730053455
Registry record updated Oct 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
33012407A Issued in IN
Practice address
600 E Hillside Dr Ste 3
Bloomington, IN 47401-6401
Phone
(812) 269-2479
NPI assigned
Oct 4, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 33012407A IN Primary

Addresses

Primary practice location

600 E Hillside Dr Ste 3
Bloomington, IN 47401-6401

Mailing address

8312 S Ashley Ave
Bloomington, IN 47401-8900
Phone (812) 269-2479

Other practice location 1

8312 S Ashley Ave
Bloomington, IN 47401-8900
Phone (812) 269-2479

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
33012407AINMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1759536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759536000000",
    "number": "1730053455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8312 S ASHLEY AVE",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474018900",
            "telephone_number": "812-269-2479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 E HILLSIDE DR STE 3",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474016401",
            "telephone_number": "812-269-2479"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8312 S Ashley Ave",
            "address_purpose": "LOCATION",
            "city": "Bloomington",
            "state": "IN",
            "postal_code": "474018900",
            "country_code": "US",
            "telephone_number": "812-269-2479",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCDERMOTT",
        "first_name": "CHERYL",
        "middle_name": "LEE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-10-04",
        "last_updated": "2025-10-04",
        "certification_date": "2025-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IN",
            "license": "33012407A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2025; 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.