Provider Demographics
NPI:1265492052
Name:FOWLER, CHERRY LINDER (LPC/MHSP)
Entity Type:Individual
Prefix:MRS
First Name:CHERRY
Middle Name:LINDER
Last Name:FOWLER
Suffix:
Gender:F
Credentials:LPC/MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:156 E PECAN VALLEY ST
Mailing Address - Street 2:
Mailing Address - City:COLLIERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38017-1955
Mailing Address - Country:US
Mailing Address - Phone:901-853-7749
Mailing Address - Fax:901-853-7749
Practice Address - Street 1:2010 EXETER RD
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38138-3945
Practice Address - Country:US
Practice Address - Phone:901-412-3191
Practice Address - Fax:901-853-7749
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN000388101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional