Provider Demographics
NPI:1235504085
Name:CROMER, CHERI NICOLE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:CHERI
Middle Name:NICOLE
Last Name:CROMER
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 1:1815 E CLAY ST
Mailing Address - Street 2:
Mailing Address - City:THOMASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31792-4736
Mailing Address - Country:US
Mailing Address - Phone:229-226-4634
Mailing Address - Fax:
Practice Address - Street 1:1358 STONE AVE
Practice Address - Street 2:
Practice Address - City:CAIRO
Practice Address - State:GA
Practice Address - Zip Code:39828-3566
Practice Address - Country:US
Practice Address - Phone:229-327-7062
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-04
Last Update Date:2015-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC008411101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional