Provider Demographics
NPI:1164151833
Name:CHERRY, PATRICIA BOWERS (LPC)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:BOWERS
Last Name:CHERRY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9936 WINDLAKE CIR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75238-2123
Mailing Address - Country:US
Mailing Address - Phone:121-450-3856
Mailing Address - Fax:
Practice Address - Street 1:9936 WINDLAKE CIR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75238-2123
Practice Address - Country:US
Practice Address - Phone:121-450-3856
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-08
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2870101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty