Provider Demographics
NPI:1073219846
Name:CHERRY-JACKSON, SHEMEKA (LCSW)
Entity Type:Individual
Prefix:
First Name:SHEMEKA
Middle Name:
Last Name:CHERRY-JACKSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3239 SHROPSHIRE BLVD # 991
Mailing Address - Street 2:
Mailing Address - City:POWELL
Mailing Address - State:TN
Mailing Address - Zip Code:37849-8400
Mailing Address - Country:US
Mailing Address - Phone:865-454-2921
Mailing Address - Fax:
Practice Address - Street 1:8207 GAMBLERS CHOICE TRL
Practice Address - Street 2:
Practice Address - City:POWELL
Practice Address - State:TN
Practice Address - Zip Code:37849-5804
Practice Address - Country:US
Practice Address - Phone:865-454-2921
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-03
Last Update Date:2023-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN75501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical