Basic Information
| Provider Information | |||||||||
| NPI: | 1972696029 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GAWLIK | ||||||||
| FirstName: | CHERYL | ||||||||
| MiddleName: | E | ||||||||
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| Credential: | MA, LLP, LMSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 13818 SHAVER CT | ||||||||
| Address2: | |||||||||
| City: | STERLING HEIGHTS | ||||||||
| State: | MI | ||||||||
| PostalCode: | 483134274 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2482448644 | ||||||||
| FaxNumber: | 2482441330 | ||||||||
| Practice Location | |||||||||
| Address1: | 888 W BIG BEAVER RD STE 1450 | ||||||||
| Address2: | |||||||||
| City: | TROY | ||||||||
| State: | MI | ||||||||
| PostalCode: | 480844762 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2482448644 | ||||||||
| FaxNumber: | 2482441330 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/02/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 6801034260 | MI | X | Behavioral Health & Social Service Providers | Social Worker | Clinical | 103TC1900X | MI | X | Behavioral Health & Social Service Providers | Psychologist | Counseling |
No ID Information.