Provider Demographics
NPI:1184232217
Name:CHERRY, REBECCA ANNE (T-LMFT)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:ANNE
Last Name:CHERRY
Suffix:
Gender:F
Credentials:T-LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5830 PLAYERS TER APT 19
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66503-2637
Mailing Address - Country:US
Mailing Address - Phone:567-283-0323
Mailing Address - Fax:
Practice Address - Street 1:1506 BROWNING AVENUE
Practice Address - Street 2:SUITE 107
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66502
Practice Address - Country:US
Practice Address - Phone:785-539-5455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-15
Last Update Date:2020-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS3158106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist