Provider Demographics
NPI:1083783591
Name:ERNEST, CHERIE M (PHD)
Entity Type:Individual
Prefix:
First Name:CHERIE
Middle Name:M
Last Name:ERNEST
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 NC HIGHWAY 902
Mailing Address - Street 2:
Mailing Address - City:PITTSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27312-8058
Mailing Address - Country:US
Mailing Address - Phone:919-542-0366
Mailing Address - Fax:919-542-6105
Practice Address - Street 1:90 NC HIGHWAY 902
Practice Address - Street 2:
Practice Address - City:PITTSBORO
Practice Address - State:NC
Practice Address - Zip Code:27312-8058
Practice Address - Country:US
Practice Address - Phone:919-542-0366
Practice Address - Fax:919-542-6105
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2008-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1054101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6103389Medicaid