Provider Demographics
NPI:1073071445
Name:CHERRY TREE COUNSELING PLLC
Entity Type:Organization
Organization Name:CHERRY TREE COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPC
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHERI
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:MATHEWS
Authorized Official - Suffix:
Authorized Official - Credentials:MSHR
Authorized Official - Phone:918-839-3458
Mailing Address - Street 1:21938 COGGINS RD
Mailing Address - Street 2:
Mailing Address - City:POTEAU
Mailing Address - State:OK
Mailing Address - Zip Code:74953-8678
Mailing Address - Country:US
Mailing Address - Phone:918-839-3458
Mailing Address - Fax:
Practice Address - Street 1:2704 N BROADWAY ST
Practice Address - Street 2:
Practice Address - City:POTEAU
Practice Address - State:OK
Practice Address - Zip Code:74953-5402
Practice Address - Country:US
Practice Address - Phone:918-839-3458
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-05
Last Update Date:2019-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)