Provider Demographics
NPI:1285186486
Name:BIDDINGER, CHERYL ANN (MS, LPC)
Entity Type:Individual
Prefix:MS
First Name:CHERYL
Middle Name:ANN
Last Name:BIDDINGER
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:MS
Other - First Name:CHERYL
Other - Middle Name:ANN
Other - Last Name:BIDDINGER-GEORGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, LLPC
Mailing Address - Street 1:1458 HIGHLAND COVE DR
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:MI
Mailing Address - Zip Code:48612
Mailing Address - Country:US
Mailing Address - Phone:989-289-7578
Mailing Address - Fax:
Practice Address - Street 1:201 S ROSS ST
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:MI
Practice Address - Zip Code:48612
Practice Address - Country:US
Practice Address - Phone:989-289-7578
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-04
Last Update Date:2019-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401015106101YP2500X, 101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor