Provider Demographics
NPI:1235752486
Name:BLANTON, CHERI LYNN (BS, QIDP, CMHP, QMHP)
Entity Type:Individual
Prefix:MRS
First Name:CHERI
Middle Name:LYNN
Last Name:BLANTON
Suffix:
Gender:F
Credentials:BS, QIDP, CMHP, QMHP
Other - Prefix:
Other - First Name:CHERI
Other - Middle Name:LYNN
Other - Last Name:ALBERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:50480 BAY RUN N
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48047-4686
Mailing Address - Country:US
Mailing Address - Phone:810-734-9879
Mailing Address - Fax:
Practice Address - Street 1:6555 15 MILE RD
Practice Address - Street 2:
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48312-4511
Practice Address - Country:US
Practice Address - Phone:586-925-4221
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-22
Last Update Date:2020-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator