Provider Demographics
NPI:1235263732
Name:SCHERER, CORALIE ROSEN (PHD)
Entity Type:Individual
Prefix:DR
First Name:CORALIE
Middle Name:ROSEN
Last Name:SCHERER
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 1:8910 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:GA
Mailing Address - Zip Code:30188-4916
Mailing Address - Country:US
Mailing Address - Phone:770-924-1818
Mailing Address - Fax:770-928-5731
Practice Address - Street 1:8910 MAIN ST
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30188-4916
Practice Address - Country:US
Practice Address - Phone:770-924-1818
Practice Address - Fax:770-928-5731
Is Sole Proprietor?:No
Enumeration Date:2007-03-15
Last Update Date:2007-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY002647103TC2200X, 103TF0000X, 103T00000X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1831109701OtherNPI CORPORATION
GA68BBGRBMedicare ID - Type Unspecified