Provider Demographics
NPI:1174683890
Name:UNDERHILL, CHERYL ANNE (LPC)
Entity Type:Individual
Prefix:MISS
First Name:CHERYL
Middle Name:ANNE
Last Name:UNDERHILL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5976 TOPAZ ST
Mailing Address - Street 2:
Mailing Address - City:PORT ARTHUR
Mailing Address - State:TX
Mailing Address - Zip Code:77640-1039
Mailing Address - Country:US
Mailing Address - Phone:409-474-0451
Mailing Address - Fax:409-736-3128
Practice Address - Street 1:3350 DOWLEN RD
Practice Address - Street 2:G
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77706-7262
Practice Address - Country:US
Practice Address - Phone:409-474-0451
Practice Address - Fax:409-736-3128
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15981101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health