Provider Demographics
NPI:1245594860
Name:SMITH, CHERIE MICHELE (LCSW)
Entity Type:Individual
Prefix:
First Name:CHERIE
Middle Name:MICHELE
Last Name:SMITH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:137 DANA DR
Mailing Address - Street 2:
Mailing Address - City:MEDINA
Mailing Address - State:TN
Mailing Address - Zip Code:38355-8778
Mailing Address - Country:US
Mailing Address - Phone:731-343-4226
Mailing Address - Fax:
Practice Address - Street 1:137 DANA DR
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:TN
Practice Address - Zip Code:38355-8778
Practice Address - Country:US
Practice Address - Phone:731-343-4226
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-28
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN6166101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health